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Survey concerning internal medicine physicians and prolonged QT interval:Knowledge and treatment practices

World Journal of Cardiology 2021年第3期13卷 42-45页

作者： Elizabeth Wendl Nelson Telles Geoff C wall Department of Medical Education Internal Medicine Residency ProgramIowa Methodist Medical CenterDes MoinesIA 50311United States Department of Cardiology Internal Medicine Residency ProgramIowa Methodist Medical CenterDes MoinesIA 50311United States Department of pharmacy practice Drake University College of Pharmacy and Health SciencesDes MoinesIA 50311United States Internal Medicine Residency program Iowa Methodist Medical CenterDes MoinesIA 50311United States

prolongation of the QT interval is associated with adverse cardiac events specifically Torsades de pointes(Tdp).There are multiple mediations that have a known,possible,or conditional risk for prolonged QT interval,but general practitioners’knowledge of these medications is *** conducted a survey to assess internal medicine(IM)providers’knowledge of risk factors and medications associated with prolonged QT as well as provider experience and comfort when treating patients with prolonged QT.A 17-question,anonymous survey was constructed in 2019 and distributed to IM providers and residents at a tertiary care *** included demographic information,6 Likert-scale questions gauging provider experience with prolonged QT,and 10 multiple choice clinical vignettes to assess clinical *** was analyzed *** was assessed via clinical vignettes and compared by level of ***-one responses were received out of a total of 87 possible respondents(47.1%response rate).About 70%of respondents see patients with acquired prolonged QT once monthly or more.95%rarely see congenital prolonged *** presented with QTc drug issues,73%of providers seldom or sometimes consulted pharmacy,but about half used online *** average correct score on the clinical vignettes was 5.59/10,with the highest scores seen in attending physicians in their first five years of practice(6.96/10).Our survey suggests that IM providers commonly encounter QT prolonging *** efforts to improve knowledge of drug and patient risk factors for Tdp may be needed.

关键词： QTc Torsades de pointes pharmacotherapy Survey Long QT syndrome Drug interactions

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Lifetime risk of esophageal adenocarcinoma in patients with Barrett's esophagus

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World Journal of Gastroenterology 2014年第28期20卷 9611-9617页

作者： piers Gatenby Christine Caygill Christine wall Santanu Bhatacharjee James Ramus Anthony Watson Marc Winslet Division of Surgery and Interventional Science UCLLondonNW32QGUnited Kingdom

AIM:To investigate the lifetime risk of development of esophageal adenocarcinoma and/or high-grade dysplasia in patients diagnosed with Barrett’s ***:Data were extracted from the United Kingdom National Barrett’s Oesophagus Registry on date of diagnosis,patient age and gender of 7877 patients from who had been registered from 35 United Kingdom *** expectancy was evaluated from United Kingdom National Statistics data based upon gender and age at year at *** data were then used with published estimates of annual adenocarcinoma and high-grade dysplasia incidences from metaanalyses and large population-based studies to estimate overall lifetime risk of development of these study ***:The mean age at diagnosis of Barrett’s esophagus was 61.6 years in males and 67.3 years in *** mean life expectancy at diagnosis was23.1 years in males,20.7 years in females and 22.2years *** data from published meta-analyses,the lifetime risk of development of adenocarcinoma was between 1 in 8 and 1 in 14 and the lifetime risk of high-grade dysplasia or adenocarcinoma was 1 in 5 to1 in *** data from 3 large recent population-based cohort studies the lifetime risk of adenocarcinoma was between 1 in 10 and 1 in 37 and of the combined endpoint of high-grade dysplasia and adenocarcinoma was between 1 in 8 and 1 in *** at Barrett’s esophagus diagnosis is reducing and life expectancy is increasing,which will partially counter-balance lower annual cancer ***:There is a significant lifetime risk of development of high-grade dysplasia and adenocarcinoma in Barrett’s esophagus.

关键词： Barrett esophagus Esophageal neoplasms Forecasting Meta-analysis Cohort studies

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Irritable bowel syndrome: A concise review of current treatment concepts

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World Journal of Gastroenterology 2014年第27期20卷 8796-8806页

作者： Geoffrey C wall Ginelle A Bryant Michelle M Bottenberg Erik D Maki rew R Miesner Department of pharmacy practice Drake University College of Pharmacy Des Moines IA 50311 United States

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders causing patients to seek medical treatment. It is relatively resource intensive and the source of significant morbidity. Recent insights into the pathophysiology and treatment of IBS has given clinicians more options than ever to contend with this disorder. The purpose of our paper is to review older, “classic” treatments for IBS as well as newer agents and “alternative” therapies. We discuss the evidence base of these drugs and provide context to help develop appropriate treatment plans for IBS patients.

关键词： Irritable bowel syndrome probiotics Rifaximin Lubiprostone Linaclotide peppermint oil

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Metal concentrations of insects associated with the South African Ni hyperaccumulator Berkheya coddii （Asteraceae）

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Insect Science 2006年第2期13卷 85-102页

作者： ROBERT S. BOYD MICHEAL A. DAVIS MICHAEL A. wall KEVIN BALKWILL Department of Biological Sciences Auburn University Auburn Department of Biological Sciences University of Southern Mississippi Hattiesburg Entomology Department San Diego Natural History Museum San Diego USA C.E. Moss Herbarium School of Animal and Plant Sciences University of the Witwatersrand South Africa

The high levels of some metals in metal hyperaccumulator plants may be transferred to insect associates. We surveyed insects collected from the South African Ni hyperaccumulator Berkheya coddii to document whole-body metal concentrations （Co, Cr, Cu, Mg, Mn, Ni, pb, Zn）. We also documented the concentrations of these metals in leaves, stems and inflorescences, finding extremely elevated levels of Ni （4 700-16 000μg/g） and high values （5-34μg/g） for Co, Cr, and pb. Of 26 insect morphotypes collected from B. coddii, seven heteropterans, one coleopteran, and one orthopteran contained relatively high concentrations of Ni （〉 500μg/g）. The large number of high-Ni heteropterans adds to discoveries of others （from California USA and New Caledonia） and suggests that members of this insect order may be particularly Ni tolerant. Nymphs of the orthopteran （Stenoscepa） contained 3 500 μg Ni/g, the greatest Ni concentration yet reported for an insect. We also found two beetles with elevated levels of Mg （〉 2 800 μg/g）, one beetle with elevated Cu （〉 70 μg/g） and one heteropteran with an elevated level of Mn （〉 200 μg/g）. Our results show that insects feeding on a Ni hyperaccumulator can mobilize Ni into food webs, although we found no evidence of Ni biomagnification in either herbivore or carnivore insect taxa. We also conclude that some insects associated with hyperaccumulators can contain Ni levels that are high enough to be toxic to vertebrates.

关键词： Berkheya coddii biomagnification food webs heavy metals hyperaccumulation,South Africa

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Oesophageal adenocarcinoma:In the era of extended lymphadenectomy,is the value of neoadjuvant therapy being attenuated?

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World Journal of Gastrointestinal Surgery 2021年第10期13卷 1235-1244页

作者： Jin-Soo park Hans Van der wall Catherine Kennedy Gregory L Falk Upper GI Surgery Concord Repatriation General HospitalSydney 2137NSWAustralia Department of Medicine University of Notre DameSydney 2007NSWAustralia CNI Molecular Imaging Notre Dame UniversitySydney 2114NSWAustralia

BACKGROUND Neoadjuvant chemotherapy(NACT)and oesophagectomy is the standard of care for resectable oesophageal *** outcomes following resection have been improving over time while NACT remain largely ***,a recent meta-analysis of randomized control trials did not demonstrate a survival benefit in adding NACT,raising the possibility that improved surgical techniques may be reducing the perceived effectiveness of *** To compare the effect of addition of NACT to a standardized surgery and lymphadenectomy on overall and disease-free survival in patients undergoing curative oesophagectomy for oesophageal *** patient data were analysed from a prospectively maintained surgical survival ***,surgical,and survival outcomes were compared between groups according to treatment and nodal *** The data of 243 consecutive patients were identified.79 patients were given NACT and 162 had surgery *** NACT group were younger,and there was less frequent stage I *** survival was similar between NACT and surgery only groups(5YS:48.7%vs 42.5%;p=0.113),as was diseasefree survival(5YS:40.6%vs 39.9%;p=0.635).There were≥30 nodes removed in 46 patients,andpatients,but were otherwise *** was improved survival in patients with≥30 nodes removed than those withp=0.015),and a better disease-free survival that neared significance(5YS:54.9%vs 36.6%;p=0.078).CONCLUSION NACT did not appear to affect overall or disease-free ***,an overall survival benefit was observed in patients with≥30 lymph nodes removed,and a benefit in disease-free survival which was not significant.

关键词： Oesophagectomy Oesophageal adenocarcinoma Neoadjuvant chemotherapy Lymphadenectomy Survival outcome Surgical technique

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The 2008 Irish Dioxin Crisis:prevention is better than Crisis Management

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食品安全质量检测学报 2010年第2期1卷 55-61页

作者： patrick wall School of public Health and Center for Food Safety University College Dublin

In Ireland, in 2008, pig feed manufactured from recycled human food became contaminated with dioxin and this led to a global recall of all Irish pork products produced from 1st September to 6th December 2008. This case study illustrates several points a) the food chain is only as secure as its weakest link, b) due to the complexity of the modern food chain, once pork is processed, precise traceability to a particular farm of origin is impossible, c) even with a single food agency, overseeing the policing of the food chain, things can go wrong, d) it demonstrated the benefits of having credible consumer protection agencies to undertake scientific risk assessment and communicate with the public, e) if risk management decisions are taken quickly, and communicated in an open and transparent manner to the public, adverse human health effects can be avoided and consumer confidence can maintained, f) in the EU the legal limit for dioxins in pork fat is 1 picogram per gram (10-12 ) and attempting to communicate the risks associated with this level of contamination plus the concepts of bioaccumulation and body burden and the need for continued exposure to result in adverse health effects is extremely challenging, g) there was a major economic impact and damage to the country's reputation as a food exporter and finally h) it illustrates that prevention is better that crisis management. Other countries can learn lessons from this incident that may prevent similar occurrences in their jurisdictions.

关键词： Dioxin Crisis management prevention Food Safety Risk Assessment, Ireland

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Seed value influences cache pilfering rates by desert rodents

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Integrative Zoology 2019年第1期14卷 75-86页

作者： Stephen B.VANDER wall Lindsay A.DIMITRI William S.LONGLAND Joseph D.M.WHITE Department of Biology and program in Ecology Evolution and Conservation BiologyUniversity of NevadaRenoUSA USDA Agricultural Research ServiceRenoNevadaUSA Department of Biological Sciences University of Cape TownCape TownRepublic of South Africa

Some rodents gather and store *** many seeds they gather and how they treat those seeds is largely determined by seed traits such as mass,nutrient content,hardness of the seed coat,presence of secondary compounds,and germination *** their consumption and dispersal of seeds,rodents act as agents of natural selection on seed traits,and those traits influence how rodents *** seeds that are scatter-hoarded by rodents are pilfered,or stolen,by other rodents,and seed traits also likely influence pilfering rates and seed fates of pilfered *** clarify coevolutionary relationships between rodents and the plants that they disperse,one needs to understand the role of seed traits in rodent foraging *** compared how the seeds of 4 species of plants that are dispersed by scatter-hoarding animals and that differ in value(singleleaf piñon pine,pinus monophylla;desert peach,prunus andersonii;antelope bitterbrush,purshia tridentata;Utah juniper,Juniperus osteosperma)were pilfered and recached by *** hundred artificial caches of the 4 seed species(25 per species)were prepared,and removal by rodents was *** pilfered high-value seeds more rapidly than the other *** peach seeds,which contain toxic secondary compounds,were more frequently *** low value seeds like Utah juniper and antelope bitterbrush were pil-fered more slowly and were sometimes left at cache sites,and seeds of the latter species were transported shorter distances to new cache *** background density of seeds also appeared to influence the relative value of seeds.

关键词： desert rodents food storage granivory pilfering scatter-hoarding seed dispersal seed traits

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Coulomb-actuated microbeams revisited: experimental and numerical modal decomposition of the saddle-node bifurcation

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Microsystems & Nanoengineering 2021年第3期7卷 111-123页

作者： Anton Melnikov Hermann A.G.Schenk Jorge M.Monsalve Franziska wall Michael Stolz Andreas Mrosk Sergiu Langa Bert Kaiser Fraunhofer Institute for photonic Microsystems IpMS Dresden 01109Germany Arioso Systems GmbH Dresden 01109Germany Brandenburg University of Technology Cottbus-Senftenberg Cottbus 03046Germany

Electrostatic micromechanical actuators have numerous applicati ons in scie nee and *** many applications,they are operated in a narrow frequency range close to resonanee and at a drive voltage of low ***,new applications,such as microelectromechanical systems(MEMS)microspeakers(μSpeakers),have emerged that require operation over a wide frequency and dynamic *** the dynamic performance under such circumstances is still highly ***-of-the-art finite element analysis struggles with pull-in instability and does not deliver the necessary in formation about un stable equilibrium states *** lumped-parameter models amenable to direct physical interpretation are *** inhibits the in dispensable in-depth analysis of the dynamic stability of such *** this paper,we take a major step towards mending the *** combining the finite element method(FEM)with an arc-length solver,we obtain the full bifurcation diagram for electrostatic actuators based on prismatic Euler-Bernoulli beams.A subsequent modal analysis then shows that within very narrow error margins,it is exclusively the lowest Euler-Bernoulli eigenmode that dominates the beam physics over the entire relevant drive voltage *** experiment directly recording the deflection profile of a MEMS microbeam is performed and confirms the numerical findings with astonishing *** enables modeling the system using a single spatial degree of freedom.

关键词： bifurcation modal narrow

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Ventilation strategies in burn intensive care:A retrospective observational study

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Burns & Trauma 2014年第1期2卷 29-35页

作者： Stefano palazzo Emma James-Veldsman Caroline wall Michelle Hayes Marcela Vizcaychipi Magill Department of Anaesthesia Intensive Care Medicine and Pain ManagementChelsea and Westminster HospitalLondonUK

Consensus regarding optimal burns intensive care(BICU)patient management is *** study aimed to assess whether ventilation strategies,cardiovascular support and sedation in BICU patients have changed over time,and whether this affects outcome.A retrospective observational study comparing two 12-patient BICU cohorts(2005/06 and 2010/11)was *** and admission characteristics,ventilation parameters,sedation,fluid resuscitation,cardiovascular support and outcome(length of stay,mortality)data were collected from patient *** was analysed using T-tests,Fisher’s exact and Mann-Whitney U *** our study cohort groups were equivalent in demographic and admission *** were equal ventilator-free days in the two cohorts 10±12.7 vs.13.3±12.2 ventilator free days;(p=0.447).The 2005/06 cohort were mechanically ventilated more often than in 2010/11 cohort(568 ventilator days/1000 patient BICU days vs.206 ventilator days/1000 patient BICU days;p=0.001).The 2005/06 cohort were ventilated less commonly in tracheostomy group/endotracheal tube spontaneous(17.8%vs.26%;p=0.001)and volumecontrolled modes(34.4%vs.40.8%;p=0.001).patients in 2010/11 cohort were more heavily sedated(p=0.001)with more long-acting sedative drug use(p=0.001)than the 2005/06 cohort,fluid administration was *** outcome did not *** injury patients were ventilated in volume-controlled(44.5%vs.28.1%;p=0.001)and pressure-controlled modes(18.2%vs.9.5%;p=0.001)more frequently than those *** did not *** study showed there has been shift away from mechanical ventilation,with increased use of tracheostomy/tracheal tube airway spontaneous *** injury patients require more ventilatory support though patient outcomes do not *** trials are required to establish which strategies confer benefit.

关键词： Burns intensive care ventilation inhalation injury

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priority setting towards achieving underfive mortality target in Africa in context of sustainable development goals:an ordinary least squares(OLS)analysis

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Global Health Research and policy 2019年第1期4卷 220-235页

作者： Michael Acheampong Chukwudi Ejiofor Abraham Salinas-Miranda Bryana wall Qiuyan Yu Center for Urban Ecology and Sustainability Suffolk University8 Ashburton PlBostonMA 02108USA College of public Health University of South Florida13201 Bruce B.Downs Blvd.MDC 56TampaFL 33612USA College of Communications and Journalism University of FloridaGainesvilleFL 32611USA School of Geosciences University of South Florida4202 E.Fowler AveTampaFL 33620USA

Background:Africa reduced its under-5 mortality rate(U5MR)by more than 50%during the MDGs ***,it still has by far the highest average U5MR in the world-81 deaths compared to a global average of 43 deaths per 1000 births,with eight of the ten countries in the world with the highest child mortality *** primary objective of our study was to examine the socioeconomic,healthcare,and environmental determinants that most account for U5MR disparities between African ***:We used a series of ordinary least squares(OLS)regression models to assess the effects of 14 distinct socioeconomic,environmental and healthcare variables that account for the high U5MR differentials that persist between African *** conducted our analysis on 43 countries for which data were *** a dummy variable,we also emphasized factors that may be accounting for the disparity between the eight worstperforming countries and the remainder of the ***:Among all the determinants analyzed in our study,the results reveal that the factors that most account for the inequities observed are,in order,expenditure on healthcare(ppper capita(ppp between the best and worst performing countries in Africa can be significantly narrowed if government and donor interventions will target downstream factors such as improving education for mothers and sensitising them about birth control since fertility rate differences play a critical *** accessibility to clean water sources to reduce outbreaks of diarrhea diseases is also observed as a critical factor.

关键词： Under-five mortality Sustainable development goals Africa Social determinants of health Health literacy

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