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temporal trends and practice variation of paediatric diagnostic tests in primary care:retrospective analysis of 14 million tests

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Family Medicine and Community Health 2024年第4期12卷 1-8页

作者： Elizabeth t thomas Diana R Withrow Cynthia Wright Drakesmith Peter j Gill Rafael Perera-Salazar Carl Heneghan Centre for Evidence-Based Medicine Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK Nuffield Department of Primary Care Health Sciences University of OxfordOxfordUK Department of Pediatrics University of TorontoTorontoOntarioCanada Hospital for Sick Children TorontoOntarioCanada

Objective the primary objective was to investigate temporal trends and between-practice variability of paediatric test use in primary *** and analysis this was a descriptive study of population-based data from Clinical Practice Research Datalink Aurum primary care consultation records from 1 january 2007 to 31 December *** aged 0–15 who were registered to one of the eligible 1464 general practices and had a diagnostic test code in their clinical record were *** primary outcome measures were(1)temporal changes in test rates measured by the average annual percent change,stratified by test type,gender,age group and deprivation level and(2)practice variability in test use,measured by the coefficient of *** 14299598 diagnostic tests were requested over 27.8 million child-years of observation for 2542101 *** test use increased by 3.6%/year(95%CI 3.4 to 3.8%)from 399/1000 child-years to 608/1000 child-years,driven by increases in blood tests(8.0%/year,95%CI 7.7 to 8.4),females aged 11–15(4.0%/year,95%CI 3.7 to 4.3),and children from the most socioeconomically deprived group(4.4%/year,95%CI 4.1 to 4.8).tests subject to the greatest temporal increases were faecal calprotectin,fractional exhaled nitric oxide and vitamin *** classified as high-use and high-practice variability were iron studies,coeliac testing,vitamin B12,folate,and vitamin *** In this first nationwide study of paediatric test use in primary care,we observed significant temporal increases and practice variability in *** reflects inconsistency in practice and diagnosis rates and a scarcity of evidence-based *** test use generates more clinical activity with significant resource implications but conversely may improve clinical *** research should evaluate whether increased test use and variability are warranted by exploring test indications and test results and directly examine how increased test use impacts

关键词： vitamin nationwide stratified

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Solvation Effects on the Dielectric Constant of 1 M LiPF6 in Ethylene Carbonate:Ethyl Methyl Carbonate 3:7

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Energy & Environmental Materials 2024年第1期7卷 253-256页

作者： julian Self Nathan t.Hahn Kristin A.Persson Department of Chemical Engineering Polytechnique MontrealMontrealQC H3T 1J4Canada Department of Materials Science and Engineering University of CaliforniaBerkeleyCA 94720USA Energy technologies Area Lawrence Berkeley National LaboratoryBerkeleyCA 94720USA Material Physical and Chemical Sciences CenterSandia National LaboratoriesAlbuquerqueNM 87185USA

We report the dielectric constant of 1 M LiPF_(6)in EC:EMC 3∶7 w/w(ethylene carbonate/ethyl methyl carbonate)in addition to neat EC:EMC 3∶7 w/*** three Debye relaxations,the static permittivity value,or dielectric constant,is extrapolated to 18.5,which is compared to 18.7 for the neat solvent *** EC solvent is found to strongly coordinate with the Li^(+)cations of the salt,which results in a loss of dielectric contribution to the ***,the small amplitude and large uncertainty in relaxation frequency for EMC cloud definitive identification of the Li^(+)solvation ***,the loss of the free EC permittivity contribution due to Li^(+)solvation is almost completely balanced by the positive contribution of the associated LiPF_(6)salt,demonstrating that a significant quantity of dipolar ion pairs exists in 1 M LiPF_(6)in EC:EMC 3∶7.

关键词： batteries dielectric relaxation spectroscopy electrolytes

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从机械机器人到智能机器人:人工智能的图像学

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外国文学研究 2024年第3期46卷 1-7页

作者： W.j.t.米切尔韦清琦(译) 美国芝加哥大学东南大学外国语学院

智能机器人将人类带入了自原子弹、电灯或是印刷术以来最伟大的科技革命之中,同时智能机器也能走火入魔这一构思也向来是科幻作品的核心想象。纵观媒体发明的历史长河,对人工智能的恐慌并不新鲜,人们曾认为书写的发明和照相术将扼杀记... 详细信息

智能机器人将人类带入了自原子弹、电灯或是印刷术以来最伟大的科技革命之中,同时智能机器也能走火入魔这一构思也向来是科幻作品的核心想象。纵观媒体发明的历史长河,对人工智能的恐慌并不新鲜,人们曾认为书写的发明和照相术将扼杀记忆和绘画,现在又照例指责数码正在毁灭模拟技术的独一性。人类应该冷静下来,采取对症下药的态度。有必要解构关于人与机器之差异的想象,而毋需躲避与智能机器人的交互谈话。人类物种虽然在作茧自缚,但同时又以进化与生态智能为基础,努力建设可持续全球体系。图像学研究的图像和文字同时包括了机器和人类的作品,因而相关的研究者应明确自己的任务:就文字与图像和智能机器人展开对话,在上述人类的生存努力中谋求与智能机器人携手合作。

关键词：智能机器人人工智能机器图像学传媒人文

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Impact of Paenibacillus elgii supernatant on screening bacterial strains with potential for biotechnological applications

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Engineering Microbiology 2024年第3期4卷 1-15页

作者： I.C.Cunha-Ferreira C.S.Vizzotto t.D.Frederico j.Peixoto L.S Carvalho M.R.tótola R.H.Krüger Laboratory of Enzymology Department of Cellular BiologyUniversity of Brasília(UNB)Brasília70910-900Brazil Laboratory of Environmental Sanitation Department of Civil and Environmental EngineeringUniversity of Brasília(UNB)Brasília70910-900Brazil Laboratório de Biotecnologia e Biodiversidade para o Meio Ambiente Universidade Federal de Viçosa(UFV)Viçosa36570-900Brazil

the biotechnological industry faces a crucial demand for novel bioactive compounds,particularly antimicrobial agents,to address the rising challenge of bacterial resistance to current available *** strate-gies for cultivating naturally occurring microorganisms often limit the discovery of novel antimicrobial *** study presents a protocol for targeted selection of bacterial strains using the supernatant of Paenibacillus el-gii,which produces abundant signal molecules and antimicrobial *** samples were inoculated in these enriched culture media to selectively cultivate bacteria resistant to the supernatant,indicating their potential to produce similar *** bacterial strains isolated through this method were assessed for their antibac-terial *** addition,the functional annotation of the genome of one of these strains revealed several gene clusters of biotechnological *** study highlights the effectiveness of using this approach for selective cultivation of microorganisms with potential for biotechnological applications.

关键词： Prospecting Supernatant Antibacterial activity

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Individual consistency in spatiotemporal characteristics of migratory Whimbrels in the East Asian-Australasian Flyway

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Avian Research 2024年第3期15卷 308-315页

作者： Siwei An Fenliang Kuang Wei Wu Chris j.Hassell jonathan t.Coleman Zijing Gao Xuena Sun Yue Yuan Grace Maglio Kar-Sin K.Leung Xuesong Feng Zhijun Ma Ministry of Education Key Laboratory for Biodiversity Science and Ecological Engineering Coastal Ecosystems Research Station of the Yangtze River EstuaryInstitute of Biodiversity ScienceSchool of Life SciencesFudan UniversityShanghai200433China School of Chemistry and Environment Yunnan Minzu UniversityKunming650504China Shanghai Chongming Dongtan Nature Reserve Administration Center ChongmingShanghai202183China Global Flyway Network PO Box 3089BroomeWA 6725Australia Australasian Wader Studies Group BroomeWA6725Australia Queensland Wader Study Group Shailer ParkQLD4128Australia Hong Kong Waterbirds Ringing Group Hong Kong999077China

Many migratory birds exhibit interannual consistency in migration schedules,routes and stopover *** the interannual consistency in spatiotemporal characteristics helps understand the maintenance of migration and enables the implementation of targeted conservation *** tracked the migration of Whimbrel(Numenius phaeopus)in the East Asian-Australasian Flyway and collected spatiotemporal data from individuals that were tracked for at least two *** non-parametric tests were used to compare the interannual variations in the dates of departure from and arrival at breeding/nonbreeding sites,and the inter-annual variation in the longitudes when the same individual across the same *** exhibited a high degree of consistency in the use of breeding,nonbreeding,and stopover sites between *** variation of arrival dates at nonbreeding sites was significantly larger than that of the departure dates from nonbreeding and breeding *** used stopover sites by the same individuals in multiple years were concentrated in the Yellow Sea coast during northward migration,but were more widespread during southward *** stopover duration at repeatedly used sites was significantly longer than that at sites used only *** flying across the Yellow Sea,Whimbrels breeding in Sakha(Yakutia)exhibited the highest consistency in migration routes in both autumn and ***,the consistency in migration routes of Yakutia breeding birds was generally higher than that of birds breeding in *** results suggest that the northward migration schedule of the Whimbrels is mainly controlled by endogenous factors,while the southward migration schedule is less affected by endogenous *** repeated use of stopover sites in the Yellow Sea coast suggests this region is important for the migration of Whimbrel,and thus has high conservation value.

关键词： Consistency Migration route Migration timing Shorebird

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Academic productivity correlates with industry earnings in foot and ankle fellowship programs in the United States:A retrospective analysis

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World journal of Orthopedics 2024年第2期15卷 129-138页

作者： Albert t Anastasio Anthony N Baumann Kempland C Walley Kyle j Hitchman Conor O’Neill jonathan Kaplan Samuel B Adams Department of Orthopedic Surgery Duke University HospitalDurhamNC 27710United States College of Medicine Northeast Ohio Medical UniversityRootstownOH 44272United States Department of Orthopedic Surgery University of MichiganAnn ArborMI 48109United States School of Osteopathic Medicine Campbell UniversityLillingtonNC 27546United States

BACKGROUND the study investigates the connection between academic productivity and industry earnings in foot and ankle orthopedic surgery *** metrics like the H-index and Open Payments Database(OPD)data,it addresses a gap in understanding the relationship between scholarly achievements and financial outcomes,providing a basis for further exploration in this specialized medical *** to elucidate the trends between academic productivity and industry earnings across foot and ankle orthopedic surgery fellowship programs in the United *** this study is a retrospective analysis of the relationship between academic productivity and industry earnings of foot and ankle orthopedic surgery fellowships at an individual faculty and fellowship *** productivity was defined via H-index and recorded from the Scopus *** earnings were recorded from the *** Forty-eight foot and ankle orthopedic surgery fellowships(100%of fellowships)in the United States with a combined total of 165 physicians(95.9%of physicians)were *** individual physician(n=165)total life-time earnings reported on the OPD website was United States Dollar(USD)451430.30±1851084.89(range:USD 25.16-21269249.85;median:USD 27839.80).Mean physician(n=165)H-index as reported on Scopus is 14.24±12.39(range:0-63;median:11).there was a significant but weak correlation between individual physician H-index and individual physician total life-time earnings(Pt and moderate positive correlation between combined fellowship H-index and total life-time earnings per fellowship(P=0.004,Spearman’s rho=0.409).CONCLUSION there is a significant and positive correlation between academic productivity and industry earnings at foot and ankle orthopedic surgery fellowships in the United *** observation is true on an individual physician level as well as on a fellowship level.

关键词： Sunshine act Foot and ankle Orthopedic surgery Orthopedic fellowship Industry earnings

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the secondary injury cascade after spinal cord injury:an analysis of local cytokine/chemokine regulation

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Neural Regeneration Research 2024年第6期19卷 1308-1317页

作者： Daniel j.Hellenbrand Charles M.Quinn Zachariah j.Piper Ryan t.Elder Raveena R.Mishra taylor L.Marti Phoebe M.Omuro Rylie M.Roddick jae Sung Lee William L.Murphy Amgad S.Hanna Department of Neurosurgery University of Wisconsin-Madison School of Medicine and Public HealthMadisonWIUSA Department of Biomedical Engineering University of Wisconsin-MadisonMadisonWIUSA Department of Orthopedics and Rehabilitation University of Wisconsin-MadisonMadisonWIUSA Department of Materials Science and Engineering University of Wisconsin-MadisonMadisonWIUSA Forward BIO Institute University of Wisconsin-MadisonMadisonWIUSA

After spinal cord injury,there is an extensive infiltration of immune cells,which exacerbates the injury and leads to further neural ***,a major aim of current research involves targeting the immune response as a treatment for spinal cord *** much research has been performed analyzing the complex inflammatory process following spinal cord injury,there remain major discrepancies within previous literature regarding the timeline of local cytokine *** objectives of this study were to establish an overview of the timeline of cytokine regulation for 2 weeks after spinal cord injury,identify sexual dimorphisms in terms of cytokine levels,and determine local cytokines that significantly change based on the severity of spinal cord *** were inflicted with either a mild contusion,moderate contusion,severe contusion,or complete transection,7 mm of spinal cord centered on the injury was harvested at varying times post-injury,and tissue homogenates were analyzed with a Cytokine/Chemokine 27-Plex *** demonstrated pro-inflammatory cytokines including tumor necrosis factorα,interleukin-1β,and interleukin-6 were all upregulated after spinal cord injury,but returned to uninjured levels within approximately 24 hours post-injury,while chemokines including monocyte chemoattractant protein-1 remained upregulated for days *** contrast,several anti-inflammatory cytokines and growth factors including interleukin-10 and vascular endothelial growth factor were downregulated by 7 days *** spinal cord injury,tissue inhibitor of metalloproteinase-1,which specifically affects astrocytes involved in glial scar development,increased more than all other cytokines tested,reaching 26.9-fold higher than uninjured *** a mild injury,11 cytokines demonstrated sexual dimorphisms;however,after a severe contusion only leptin levels were different between female and male *** conclusion,pro-inflammatory cytokines in

关键词： astrocytes chemokines cytokines inflammation macrophages microglia secondary damage spinal cord injury

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QCD sum rule study of j^(P)=1^(±)exotic states with two heavy quarks in the molecular picture

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Chinese Physics C 2024年第6期48卷 31-37页

作者： t.M.Aliev S.Bilmis M.Savcı Department of Physics Middle East Technical UniversityAnkara06800Turkey tUBItAK ULAKBIM Ankara06510Turkey

In this study,the spectroscopic parameters of exotic molecular states composed of mesons containing two heavy quarks(scalar-axial and pseudoscalar-axial meson combinations)are investigated within the QCD sum *** findings reveal that molecular states containing charm quarks do not form bound states,whereas states with b-quarks can form exotic molecular *** observation has significant implications for understanding the structure of these exotic states.

关键词： QCD sum rules exotic mesons molecular states

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Enhanced and asymmetric signatures of hybridization at climatic margins: Evidence from closely related dioecious fig species

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Plant Diversity 2024年第2期46卷 181-193页

作者： jian-Feng Huang Clive t.Darwell Yan-Qiong Peng CAS Key Laboratory of tropical Forest Ecology Xishuangbanna Tropical Botanical GardenChinese Academy of SciencesMengla 666303China National Center for Genetic Engineering and Biotechnology(BIOtEC) 113 Thailand Science ParkPhahonyothin RoadKhlong NuengKhlong LuangPathum Thani 12120Thailand

Hybridization plays a significant role in biological evolution. However, it is not clear whether ecological contingency differentially influences likelihood of hybridization, particularly at ecological margins where parental species may exhibit reduced fitnesses. Moreover, it is unknown whether future ecosystem change will increase the prevalence of hybridization. Ficus heterostyla and F. squamosa are closely related species co-distributed from southern thailand to southwest China where hybridization, yielding viable seeds, has been documented. As a robust test of ecological factors driving hybridization, we investigated spatial hybridization signatures based on nuclear microsatellites from extensive population sampling across a widespread contact range. Both species showed high population differentiation and strong patterns of isolation by distance. Admixture estimates exposed asymmetric interspecific gene *** of hybridization increase significantly towards higher latitude zones, peaking at the northern climatic margins. Geographic variation in reproductive phenology combined with ecologically challenging marginal habitats may promote this phenomenon. Our work is a first systematic evaluation of such patterns in a comprehensive, latitudinally-based clinal context, and indicates that tendency to hybridize appears strongly influenced by environmental conditions. Moreover, that future climate change scenarios will likely alter and possibly augment cases of hybridization at ecosystem scales.

关键词： Hybridization Heterospecific visitation Fig Pollinator wasp Asymmetric gene flow

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Metrology for sub-Rayleigh-length target positioning in~10^(22)W/cm^(2)laser-plasma experiments

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High Power Laser Science and Engineering 2024年第3期12卷 90-105页

作者： E.A.Vishnyakov A.Sagisaka K.Ogura t.Zh.Esirkepov B.Gonzalez-Izquierdo C.D.Armstrong t.A.Pikuz S.A.Pikuz W.Yan t.M.jeong S.Singh P.Hadjisolomou O.Finke G.M.Grittani M.Nevrkla C.M.Lazzarini A.Velyhan t.Hayakawa Y.Fukuda j.K.Koga M.Ishino K.Kondo Y.Miyasaka A.Kon M.Nishikino Y.V.Nosach D.Khikhlukha I.P.tsygvintsev D.Kumar j.Nejdl D.Margarone P.V.Sasorov S.Weber M.Kando H.Kiriyama Y.Kato G.Korn K.Kondo S.V.Bulanov t.Kawachi A.S.Pirozhkov ELI Beamlines Facility The Extreme Light Infrastructure ERICDolníBrežanyCzech Republic Kansai Institute for Photon Science(KPSI) QSTKyotoJapan Central Laser Facility Rutherford Appleton LaboratorySTFCHarwell OxfordDidcotUK Institute for Open and transdisciplinary Research Initiatives Osaka UniversityOsakaJapan HB11 Energy Holdings FreshwaterAustralia Key Laboratory for Laser Plasmas(Ministry of Education) School of Physics and AstronomyShanghai Jiao Tong UniversityShanghaiChina Collaborative Innovation Center of IFSA Shanghai Jiao Tong UniversityShanghaiChina Institute of Plasma Physics ASCR PragueCzech Republic FZU-Institute of Physics ASCR PragueCzech Republic Czech technical University in Prague FNSPEPragueCzech Republic Institute of Laser Engineering Osaka UniversityOsakaJapan Institute of Physics National Academy of Sciences of UkraineKyivUkraine IStEQ AR YerevanArmenia

tight focusing with very small f-numbers is necessary to achieve the highest at-focus ***,tight focusing imposes strong demands on precise target positioning in-focus to achieve the highest on-target irradiance We describe several near-infrared,visible,ultraviolet and soft and hard X-ray diagnostics employed in a~10^(22)W/cm^(2)laser±plasma *** used nearly 10 j total energy femtosecond laser pulses focused into an approximately1.3-μm focal spot on 5±20μm thick stainless-steel *** discuss the applicability of these diagnostics to determine the best in-focus target position with approximately 5μm accuracy(i.e.,around half of the short Rayleigh length)and show that several diagnostics(in particular,3ωreflection and on-axis hard X-rays)can ensure this *** demonstrated target positioning within several micrometers from the focus,ensuring over 80%of the ideal peak laser intensity *** approach is relatively fast(it requires 10±20 laser shots)and does not rely on the coincidence of low-power and high-power focal planes.

关键词： laser-plasma interaction precise target positioning spectroscopy ultra-high intensity X-rays

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