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Current management of gastro-oesophageal reflux disease—treatment costs,safety profile,and effectiveness:a narrative review

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Gastroenterology Report 2023年第1期11卷 95-113页

作者： Tahmina Lata Jodie Trautman Philip Townend robert b.Wilson Faculty of Medicine and Health University of SydneyCamperdownNSWAustralia Upper Gastrointestinal Surgery Department University of New South WalesLiverpool HospitalLiverpoolNSWAustralia General Surgery Department Wollongong HospitalWollongongNSWAustralia General Surgery Department Gold Coast University HospitalSouthportQLDAustralia

b.ckground The purpose of this study was to review the current management of gastro-oesophageal reflux disease(GORD),including treatment costs,safety profile and *** A literature review was performed of randomized-controlled trials,systematic reviews,Cochrane reports and National/Societal guidelines of themedical,endoscopic and surgicalmanagement of *** pump inhib.tor(PPI)prescrib.ng patterns and expenditure were reviewed in different countries,including Australia,Canada,New Zealand,UK and *** Proton pump inhib.tors(PPIs)are primarily indicated for control of GORD,Helicob.cter pylori eradication(comb.ned with antib.otics),preventing NSAID-induced gastrointestinal b.eeding and treating peptic ulcer *** is widespread overprescrib.ng of PPIs in Western and Eastern nations in terms of indication and duration,with sub.tantial expense for national health *** a favourab.e short-term safety profile,there are ob.ervational associations of adverse effects with long-term *** include nutrient malab.orption,enteric infections and cardiovascular *** prevalence of PPI use makes their long-termsafety profile clinically ***-b.nefit,symptom control and quality-oflife outcomes favour laparoscopic fundoplication rather than chronic PPI *** fundoplication in long-termmanagement of PPI-responsive GORD is supported b. SAGES,NICE and ACG,and PPI-refractory GORD b. AGA and SAGES *** importance of estab.ishing a definitive diagnosis prior to invasive management is emphasized,especially in PPI-refractory *** We examined evidence-b.sed guidelines for PPI prescrib.ng and deprescrib.ng in primary care and hospital settings and the need for PPI stewardship and education of health *** narrative review presents the advantages and disadvantages of surgical,endoscopic and medical management of GORD,which may assist in shared decision making and treatment cho

关键词： Canada treatment estab.ishing

Superior growth performance in b.oiler chicks fed chelated compared to inorganic zinc in presence of elevated dietary copper

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Journal of Animal Science and b.otechnology 2016年第4期7卷 561-569页

作者： Junmei Zhao robert b. Shirley Julia J. Dib.er Karen J. Wedekind Frances Yan Paula Fisher Thomas R. Hampton Joseph L. Evans Mercedes Vazquez-Anon research and development novus international20 Research Park DriveSaint CharlesMO 63304USA current affiliation:poultry technical services adisseo usaAlpharettaGA 30022USA

b.ckground： The goal of this study was to compare the antagonism of elevated dietary Cu （250 mg/kg） from CuS04 on three different Zn sources （ZnS04. H20; [Zn b.s（-2-hydroxy-4-（methylthio）b.tanoic acid）], Zn（HMTb.）2 a chelated Zn methionine hydroxy analogue; and Zn-Methionine）, as measured using multiple indices of animal performance in ROSS 308 b.oilers. Methods： Three experiments were conducted in b.oiler chicks fed a semi-purified diet. All b.rds were fed a Zn-deficient diet （8.5 mg/kg diet） for 1 wk, and then provided with the experimental diets for 2 wks. Results： Experiment 1 was a 2 x 2 factorial design with two levels of Cu （8 vs. 250 mg/kg diet from CuSO4） and two Zn sources at 30 mg/kg [ZnSO4. H20 vs. Zn（HMTb.）2]. Elevated Cu impaired growth performance only in b.rds fed ZnSO4. Compared to ZnSO4. H20, Zn（HMTb.）2 improved feed intake （12 %; P 〈 0.001） and weight gain （12 %, P 〈 0.001） and the b.nefits were more pronounced in the presence of 250 mg/kg diet Cu. Experiment 2 was a dose titration of ZnSO4- H20 and Zn（HMTb.）2 at 30, 4,5, 60, and 75 mg/kg diet in the presence of 250 mg/kg CuSO4. Feed：gain was decreased and tib.a Zn was increased with increasing Zn levels from 30 to 75 mg/kg. b.rds fed Zn（HMTb.）2 consumed more food and gained more weight compared to b.rds fed ZnSO4, especially at lower supplementation levels （30 and 45 mg/kg; interaction P 〈 0,05）. Experiment 3 compared two organic Zn sources （Zn（HMTb.）2 vs. Zn-Methionine） at 30 mg/kg with or without 250 mg/kg CuSO4. No interactions were ob.erved b.tween Zn sources and Cu levels on performance or tissue mineral concentrations. High dietary Cu decreased weight gain （P 〈 0.01）. Tib.a Cu and liver Cu were significantly increased with 250 mg/kg dietary Cu supplementation （P 〈 0.01）. No difference was ob.erved b.tween the two Zn sources. Conclusions： Dietary 250 mg/kg Cu significantly impaired feed intake and weight gain in b.rds fed ZnSO4. H20, b.t had less impact in b.rds fed Zn（HMTb.）2. No difference

关键词： Antagonism b.oilers Chelates Growth MineraLs Organic Performance

b.ron isotopic variations in tourmaline from metacarb.nates and associated calc-silicate rocks from the b.hemian Massif: Constraints on b.ron recycling in the Variscan orogen

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Geoscience Frontiers 2021年第1期12卷 219-230页

作者： Lukas Krmcek Milan Novak robert b.Trumb.ll Jan Cempirek Stanislav Houzar Department of Geological Sciences Faculty of ScienceMasaryk UniversityKotlarska 2CZ-61137BrnoCzech Republic Institute of Geology of the Czech Academy of Sciences Rozvojova 269CZ-16502Prague 6Czech Republic b.no University of Technology Faculty of Civil EngineeringAdMaS CentreVeve■rí95CZ-60200BrnoCzech Republic GFZ German Research Centre for Geosciences TelegrafenbergD-14473PotsdamGermany Department of Mineralogy and Petrography Moravian MuseumZelnyTrh 6CZ-67401BrnoCzech Republic

Various metacarb.nate and associated calc-silicate rocks form minor b.t genetically significant components of the lithological units in the b.hemian Massif of the Variscan orogen in Central *** rocks vary in terms of their lithostratigraphy,chemical composition and mineral assemb.age(dolomite/calcite ratio,silicate ab.ndance).Tourmaline is present in five paragenetic settings within the metacarb.nate and calc-silicate ***Ⅰcomprises individual,euhedral,prismatic grains and grain aggregates in a carb.nate-dominant(calcite±dolomite)matrix poor in ***Ⅱis characterized b. euhedral to sub.edral grains and coarse-to fine-grained aggregates in silicate-rich layers/nests within metacarb.nate b.dies whereas typeⅢoccurs as prismatic grains and aggregates at the contact zones b.tween carb.nate and associated silicate host ***Ⅳis in veins crosscutting metacarb.nate b.dies,and typeⅣtourmaline occurs at the exocontacts of elb.ite-sub.ype granitic *** from the different settings shows distinctive compositional *** for typeⅠare Mg-rich compositions,with fluor-uvite>dravite>>*** from typeⅡsilicate-rich layers/nests are highly variab.e,corresponding to oxy-schorl,magnesio-foitite,Al-rich dravite and *** for typeⅢtourmalines are Ca,Ti-b.aring oxy-dravite *** typeⅣveins feature dravite and fluor-uvite tourmaline compositions whereas typeⅤtourmaline is Li,F-rich *** is the only b.earing phase in paragenetic typesⅠ-Ⅳ,where it is characterised b. two principal ranges of b.isotope composition(δ^11b.-13‰to-9‰and-18‰to-14‰).These ranges correspond to regionally different units of the Moldanub.an ***,the Svratka Unit(Moldanub.an Zone s.l.)contains only isotopically lighter tourmaline(δ^11b.-18‰to-14‰),whereas metacarb.nates in the Poli?ka unit(Teplá-b.rrandian Zone)and Olesnice unit(Moravicum of the Moravo-Silesian Zone)has exclusively isotopically heav

关键词： b.ron isotopes Tourmaline Metacarb.nates Moldanub.cum Variscan orogeny

Investigation of Gamma-Emitting Natural Radioactive Contents in Three Types of Vernonia Consumed in Cameroon

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World Journal of Nuclear Science and Technology 2011年第2期1卷 37-45页

作者： Thomas b. Makon robert Martin Nemb. Pascal Tchokossa Department of Physics Obafemi Awolowo University Ile-Ife Nigeria

The specific activity concentration and the derived Annual Effective Dose(AED) in three types of vernonia cultivated and consumed within and outside Cameroon were measured b. means of a well-calib.ated high-purity germanium detector. Vernonia samples were collected directly from the production farms, oven-dried to a constant mass, crushed, sieved and sealed for at least a month b.fore analysis. The specific activity of 238U in the three types of vernonia ranged from 20 - 50 b. kg-1 with an average of 42 ± 15 b. kg-1, 232Th from 9 - 22 b. kg-1 with an average of 17 ± 7 b. kg-1 while 40K ranged from 115 - 460 b. kg-1 with an average of 302 ± 36 b. kg-1. The average AED for 40K, 238U and 232Th were 0.15, 0.92 and 0.92μSv y-1 respectively. 238U and 232Th show the same trends b.th for the regional distrib.tion of the radioactivity content and the AED. The discrepancies in our data can b. attrib.ted to many factors such as geological formation, foliar deposition, type and age of the plant, etc. Although the results ob.ained represent only some fractions of the standard limit, b.t they are within some range ob.ained in other countries.

关键词： Radionuclides Specific Activity Dose Vernonia Gamma-Ray Cameroon

Extensor pollicis b.evis tendon can hyperextend thumb.interphalangeal joint in ab.ence of extensor pollicis longus:Case report and review of the literature

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World Journal of Orthopedics 2016年第7期7卷 448-451页

作者： robert J Strauch Carolyn b.Strauch Department of Orthopaedic Surgery Columbia University Dartmouth College

We are reporting a case of extensor pollicis longus tendon rupture which did not require tendon transfer owing to the ab.lity of the intact extensor pollicis b.evis(EPb. to fully hyperextend the thumb.interphalangeal joint. The thumb.metacarpophalangeal joint was also ab.e to b. fully actively extended b. the EPb. Previous anatomical studies have demonstrated that the insertional anatomy of the EPb.tendon is highly variab.e and sometimes inserts onto the extensor hood and distal phalanx, which is likely the mechanism b. which our patient was ab.e to fully extend the thumb.interphalangeal joint. Despite the potential for the EPb.to extend the IP joint of the thumb. virtually all previously reported cases of extensor pollicis longus(EPL) tendon rupture had deficits of thumb.IP extension requiring tendon transfer. This case highlights the potential ab.lity of the EPb.tendon to completely sub.titute for the function of the EPL tendon in providing thumb.IP joint extension.

关键词： Extensor pollicis b.evis Extensor pollici longus Tendon rupture Extensor pollicis longus tendon rupture

Iron, calcite, and oxidative stress in coal dust-induced lung diseases

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Chinese Journal Of Geochemistry 2006年第B08期25卷 216-217页

作者： Xi HUANG Jisen DAI robert b. Finkelman Department of Environmental Medicine NYU School of Medicine New York USA US Geological Survey Reston Virginia USA

Interactions of complement proteins C1q and factor H with lipid A and Escherichia coli:further evidence that factor H regulates the classical complement pathway

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Protein & Cell 2011年第4期2卷 320-332页

作者： Lee Aun Tan Andrew C.Yang Uday Kishore robert b.Sim Medical Research Council Immunochemistry Unit Department of BiochemistryUniversity of OxfordSouth Parks RoadOxford OX13QUUK Present address:Department of Immunology Faculty of MedicineImperial College LondonHammersmith HospitalDu Cane RoadLondon W120NNUK St Peter’s College New Inn Hall St.Oxford OX12DLUK Present address:SUNY Downstate College of Medicine 450 Clarkson Avenue BrooklynNY 11203USA Weatherall Institute of Molecular Medicine John Radcliffe HospitalUniversity of OxfordHeadingtonOxford OX39DSUK Present address:Center for Infection Immunity and Disease MechanismsBiosciencesSchool of Health Sciences and Social CareBrunel UniversityUxbridge UB83PH West LondonUK Present address:Department of Pharmacology University of OxfordMansfield RoadOxford OX13QTUK

Proteins of the complement system are known to interact with many charged *** recently characterized b.nding of C1q and factor H to immob.lized and liposomal anionic *** H inhib.ted C1q b.nding to anionic phospholipids,suggesting a role for factor H in regulating activation of the complement classical pathway b. anionic *** extend this finding,we examined interactions of C1q and factor H with lipid A,a well-characterized activator of the classical *** report that C1q and factor H b.th b.nd to immob.lized lipid A,lipid A liposomes and intact Escherichia coli *** H competes with C1q for b.nding to these ***,increasing the factor H:C1q molar ratio in serum diminished C4b.fixation,indicating that factor H diminishes classical pathway *** recomb.nant forms of the Cterminal,glob.lar heads of C1q A,b.and C chains b.und to lipid A and *** in a manner qualitatively similar to native C1q,confirming that C1q interacts with these targets via its glob.lar head *** ob.ervations reinforce our proposal that factor H has an additional complement regulatory role of down-regulating classical pathway activation in response to certain *** is distinct from its role as an alternative pathway *** suggest that under physiological conditions,factor H may serve as a downregulator of b.cterially-driven inflammatory responses,thereb. finetuning and b.lancing the inflammatory response in infections with Gram-negative b.cteria.

关键词： complement lipid A b.cteria factor H C1q

Complement activation b. phospholipids: the interplay of factor H and C1q

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Protein & Cell 2010年第11期1卷 1033-1049页

作者： Lee Aun Tan b.ngb.n Yu Francis CJ Sim Uday Kishore robert b.Sim MRC Immunochemistry Unit Department of BiochemistryUniversity of OxfordSouth Parks RdOxford OX13QUUK Department of Pharmacology University of OxfordMansfield RoadOxford OX13QTUK Centre for Infection Immunity and Disease MechanismsBiosciencesSchool of Health Sciences and Social CareBrunel UniversityUxbridge UB83PH West LondonUK Present address Department of Immunology Faculty of MedicineImperial College LondonHammersmith HospitalDu Cane RoadLondon W120NNUK Present address School of Life Sciences and Engineering Biology BuildingTsinghua UniversityBeijing 100084China

Complement proteins in b.ood recognize charged *** anionic phospholipid(aPL)cardiolipin b.nds b.th complement proteins C1q and factor H.C1q is an activator of the complement classical pathway,while factor H is an inhib.tor of the alternative *** examine opposing effects of C1q and factor H on complement activation b. aPL,we surveyed C1q and factor H b.nding,and complement activation b. aPL,either coated on microtitre plates or in *** C1q and factor H b.und to all aPL tested,and competed directly with each other for *** the aPL activated the complement classical pathway,b.t negligib.y the alternative pathway,consistent with accepted roles of C1q and factor ***,in this system,factor H,b. competing directly with C1q for b.nding to aPL,acts as a direct regulator of the complement classical *** regulatory mechanism is distinct from its action on the alternative *** of classical pathway activation b. factor H was confirmed b. measuring C4 activation b. aPL in human sera in which the C1q:factor H molar ratio was adjusted over a wide *** factor H,which is regarded as a down-regulator only of the alternative pathway,has a distinct role in downregulating activation of the classical complement pathway b. aPL.A factor H homologue,β2-glycoprotein-1,also strongly inhib.ts C1q b.nding to *** glob.lar domains of C1q A,b.and C chains b.und aPL similarly to native C1q,confirming that C1q b.nds aPL via its glob.lar heads.

关键词： complement regulation classical pathway C1q factor H anionic phospholipid

Pediatric interfacility transport effects on mortality and length of stay

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World Journal of Pediatrics 2021年第4期17卷 400-408页

作者： Rod M.Shinozaki Andreas Schwingshackl Neeraj Srivastava Tristan Grogan robert b.Kelly David Geffen School of Medicine at UCLA Los AngelesCAUSA University of California IrvineIrvineCAUSA Children’s Hospital of Orange County 1201 West La Veta AvenueOrangeCA92868USA

b.ckground We aimed to evaluate the effects of interfacility pediatric critical care transport response time,physician presence during transport,and mode of transport on mortality and length of stay(LOS)among pediatric *** hypothesized that a shorter response time and helicopter transports,b.t not physician presence,are associated with lower mortality and a shorter *** Retrospective,single-center,cohort study of 841 patients(b.tween 2014 and 2018 utilizing patient charts and transport *** linear and logistic regression analyses adjusted for age,diagnosis,mode of transport,response time,stab.lization time,return duration,mortality risk(pediatric index of mortality-2 and pediatric risk of mortality-3),and inotrope,vasopressor,or mechanical ventilation presence on *** Four hundred and twenty-eight(50.9%)patients were transported b. helicopter,and 413(49.1%)were transported b. *** accompanied 239(28.4%)*** median response time was 2.0(interquartile range 1.4–2.9)*** physician presence increased the median response time b. 0.26 hours(P=0.020),neither physician presence nor response time significantly affected mortality,ICU length of stay(ILOS)or hospital length of stay(HLOS).Helicopter transports were not significantly associated with mortality or ILOS,b.t were associated with a longer HLOS(3.24 days,95%confidence interval 0.59–5.90)than amb.lance transports(P=0.017).Conclusions These results suggest response time and physician presence do not significantly affect mortality or *** may reflect the quality of pre-transport care and medical control *** transports were only associated with a longer *** analysis provides a framework for examining transport workforce needs and associated costs.

关键词： Helicopter Hospital length of stay Pediatric critical care Pediatric intensive care unit Transport medicine