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Stricter national standards are required for credentialing of endoscopic-retrograde-cholangiopan-creatography in the United States

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World Journal of Gastroenterology 2019年第27期25卷 3468-3483页

作者： mitchell S Cappell david m Friedel Division of Gastroenterology and Hepatology William Beaumont HospitalRoyal OakMI 48073United States Oakland University William Beaumont School of medicine William Beaumont HospitalMI 48073United States Division of Gastroenterology New York University Winthrop Medical CenterMineolaNY 11501United States

Endoscopic-retrograde-cholangiopancreatography(ERCP) is now a vital modality with primarily therapeutic and occasionally solely diagnostic utility for numerous biliary/pancreatic disorders. It has a significantly steeper learning curve than that for other standard gastrointestinal(GI) endoscopies, such as esophagogastroduodenoscopy or colonoscopy, due to greater technical difficulty and higher risk of complications. Yet, GI fellows have limited exposure to ERCP during standard-three-year-GI-fellowships because ERCP is much less frequently performed than esophagogastroduodenoscopy/colonoscopy. This led to adding an optional year of training in therapeutic endoscopy. Yet many graduates from standard three-year-fellowships without advanced training intensely pursue independent/unsupervised ERCP privileges despite inadequate numbers of performed ERCPs and unacceptably low rates of successful selective cannulation of desired(biliary or pancreatic) duct. Hospital credentialing committees have traditionally performed ERCP credentialing, but this practice has led to widespread flouting of recommended guidelines(e.g., planned privileging of applicant with 20% successful cannulation rate, or after performing only 7 ERCPs);and intense politicking of committee members by applicants, their practice groups, and potential competitors. Consequently, some gastroenterologists upon completing standard fellowships train and learn ERCP 'on the job' during independent/unsupervised practice, which can result in bad outcomes: high rates of failed bile duct cannulation. This severe clinical problem is indicated by publication of ≥ 12 ERCP competency studies/guidelines during last 5 years. However, lack of mandatory, quantitative, ERCP credentialing criteria has permitted neglect of recommended guidelines. This work comprehensively reviews literature on ERCP credentialing;reviews rationales for proposed guidelines;reports problems with current system;and proposes novel criteria for competenc

关键词： Endoscopic retrograde cholangiopancreatography Privileges Credentialing Gastroenterology fellowship training Advanced gastrointestinal endoscopy training Certification Standards

Determinants of male health： the interaction of biological and social factors

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Asian Journal of Andrology 2010年第3期12卷 291-297,I0007页

作者： david m. de Kretser（澳大利亚） monash University Clayton Victoria 3168 Australia

This review discusses the social and biological factors that may influence male development from conception to adulthood and also underlie the development of health disorders. It will provide assistance to those who may be considering the formulation of a male health policy. It aims to emphasize that social determinants function on a bio- logical background that is profoundly influenced by a male＇s genome, inherited from his parents. The importance of the male-specific reproductive disorders is emphasized, but these also affect somatic structures through the secretion of androgens secreted from the testes. In turn, the function of the cardiovascular and nervous systems can signifi- cantly influence reproductive processes such as erectile dysfunction.

关键词： infertility genetics impotence health policy

Practice of Barrier measures against COVID-19 Among Diabetic People Followed at Departmental University Hospital Center Ouémé-Plateau, Benin, in 2021

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Open Journal of Epidemiology 2024年第2期14卷 249-259页

作者： Yèssito Corine Nadège Houehanou Armand Wanvoègbe Akouodé Thomas Hounto Luc Béhanzin maurice Agonnoudé david Houéto Thierry Adoukonou National School of Public Health (ENATSE) University of Parakou Parakou Benin Department of Internal medicine University Departmental Hospital Ou&#233me-Plateau Porto-Novo Benin

Introduction: COVID-19 is a pandemic disease caused by the coronavirus SARS-COV2 appeared in China in 2019. The aim of the study was to evaluate the practice of barrier measures against COVID-19 and to identify associated factors among diabetics followed at Departmental University Hospital Center Ouémé-Plateau, Benin, in 2021. methods: This was a cross-sectional study conducted from June to August 2021, including diabetics aged 18 and over, hospitalized or received for medical visits in the department of medicine at the target hospital. Data were collected during an interview with each participant thanks to a questionnaire. “Good practice” was defined as regular practice of at least two of three barrier measures: hand washing, physical distancing and mask-wearing. Results: A total of 110 diabetics were included with a female predominance (55.5%) and a mean age of 57 ± 11.3 years. Among them, 89.1% washed their hands, 41.8% respected physical distancing and 12.7% wore a mask. The proportion of good practice was 47.3%. Only 5 practiced the three barrier measures. Only age group was associated with good practice. Conclusion: The study showed a low proportion of good practice of barrier measures against COVID-19 among diabetic people surveyed. It is important to continue the action for COVID-19 prevention among diabetic people in the targeted hospital and in other hospitals in Benin.

关键词： COVID-19 Barrier measures Practice Diabetic People Benin

Field Phenomics:Will It Enable Crop Improvement?

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Plant Phenomics 2021年第1期3卷 310-325页

作者： david m.Deery Hamlyn G.Jones CSIRO Agriculture and Food CanberraACTAustralia Division of Plant Sciences University of DundeeUK School of Agriculture and Environment University of Western AustraliaAustralia

Field phenomics has been identified as a promising enabling technology to assist plant breeders with the development of improved cultivars for ***,despite much investment,there are few examples demonstrating the application of phenomics within a plant breeding *** review recent progress in field phenomics and highlight the importance of targeting breeders’needs,rather than perceived technology needs,through developing and enhancing partnerships between phenomics researchers and plant breeders.

关键词： breeding cultivar Crop

Bubble Coalescence Heat Transfer During Subcooled Nucleate Pool Boiling

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工程热物理学报 2012年第12期33卷 2171-2175页

作者： Abdoulaye Coulibaly LIN Xipeng Bi Jingliang david m Christopher Department of Thermal Engineering Tsinghua University

Bubble coalescence during subcooled nucleate pool boiling was investigated experimentally using constant wall temperature boundary conditions while the wall heat flux was measured at a various locations to understand the effects of coalescence on the heat *** observations showed that the coalesced bubble moved and oscillated on the heater surface with significant heat transfer variations prior to *** observations also showed coalescence with no increase in the heat transfer *** heat flux for boiling with coalescence fluctuated much more than for single bubble boiling due to the vaporization of the liquid layer trapped between the bubbles.

关键词： microheater pool boiling bubble coalescence bubble dynamics

Influence of humidity on conduction processes in gas-insulated devices

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High Voltage 2020年第2期5卷 143-150页

作者： malte Tschentscher david Graber Christian m.Franck High Voltage Laboratory ETH Zurich8092 ZurichSwitzerland

Humidity has been considered as one of the main influencing factors that determine the conduction processes and electric strength of gas-insulated *** in the past,various studies focused on the change in the partial discharge inception voltages,breakdown strength of homogeneous and inhomogeneous field arrangements,and insulator flashover voltage,recent studies have investigated the changes in ion currents measured through different gas *** the framework of this contribution,a highly precise humidity control circuit has been developed to analyse the significance of humidity in the range from−25 to−5°C frost-point,which is fully applicable to operating gas-insulated *** sulphur hexafluoride(SF6)as the insulation gas at 0.45 mPa,Al2O3-filled epoxy resin insulators,and technically rough electrodes,the humidity was found to significantly influence the intensity of microdischarges at *** generation from microdischarges at the interfaces substantially increased with increasing *** an electric field of 5 kV/mm that were applicable to the dimensioning of gas-insulated devices,humidity strongly influences the charge provision from technically rough interfaces and potentially contributes to the surface-charge accumulation at insulator *** the other hand,for low-field conduction phenomena,no increase in the ion currents from natural ionisation or electrophoretic conduction was *** the investigated range of parameters,humidity is expected to be highly relevant for the design of gas-insulated devices.

关键词： conduction humidity sulphur

Cost-Effectiveness of Interventions for Alternate Food to Address Agricultural Catastrophes Globally

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International Journal of Disaster Risk Science 2016年第3期7卷 205-215页

作者： david C.Denkenberger Joshua m.Pearce Global Catastrophic Risk Institute Department of Civil and Architectural Engineering Tennessee State University Department of materials Science and Engineering Michigan Technological University Department of Electrical and Computer Engineering Michigan Technological University

The literature suggests there is about a 1 % risk per year of a 10 % global agricultural shortfall due to catastrophes such as a large volcanic eruption, a medium asteroid or comet impact, regional nuclear war, abrupt climate change, and extreme weather causing multiple breadbasket failures. This shortfall has an expected mortality of about 500 million people. To prevent such mass starvation, alternate foods can be deployed that utilize stored biomass. This study developed a model with literature values for variables and, where no values existed,used large error bounds to recognize uncertainty. Then monte Carlo analysis was performed on three interventions: planning, research, and development. The results show that even the upper bound of USD 400 per life saved by these interventions is far lower than what is typically paid to save a life in a less-developed country. Furthermore, every day of delay on the implementation of these interventions costs 100–40,000 expected lives(number of lives saved multiplied by the probability that alternate foods would be required). These interventions plus training would save 1–300 million expected lives. In general, these solutions would reduce the possibility of civilization collapse, could assist in providing food outside of catastrophic situations, and would result in billions of dollars per year of return.

关键词： Agricultural catastrophe Alternate food Global catastrophic risk Intervention cost-effectiveness

Electronic correlation in nearly free electron metals with beyond-DFT methods

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npj Computational materials 2022年第1期8卷 1756-1762页

作者： Subhasish mandal Kristjan Haule Karin m.Rabe david Vanderbilt Department of Physics and Astronomy West Virginia UniversityMorgantownWVUSA Department of Physics and Astronomy Rutgers UniversityPiscatawayNJUSA

For more than three decades,nearly free-electron elemental metals have been a topic of debate because the computed bandwidths are significantly wider in the local density approximation to density-functional theory(DFT)than indicated by angle-resolved photoemission(ARPES)***,we systematically investigate this using first principles calculations for alkali and alkaline-earth metals using DFT and various beyond-DFT methods such as meta-GGA,G0W0,hybrid functionals(YS-PBE0,B3LYP),and LDA+*** find that the static non-local exchange,as partly included in the hybrid functionals,significantly increase the bandwidths even compared to LDA,while the G0W0 bands are only slightly narrower than in *** agreement with the ARPES is best when the local approximation to the self-energy is used in the LDA+eDmFT *** infer that even moderately correlated systems with partially occupied s orbitals,which were assumed to approximate the uniform electron gas,are very well described in terms of short-range dynamical correlations that are only local to an atom.

关键词： metals assumed narrow

THE DEmOCRATIC CONTROL OF PUBLIC SPENDING IN CLASSICAL ATHENS

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Journal of Ancient Civilizations 2019年第2期34卷 229-243,329页

作者： david m Pritchard L’Universitéde Lyon/The University of Queensland

This article challenges the famous argument of Lisa Kallet that the Athenian people did not understand public *** argues that the dēmos(“people”)had the necessary general knowledge and the necessary understanding of the state’s budget to make independent financial *** democratic council and politicians kept them well informed on the overall fiscal position of *** adjudicating public debates about the state’s budget they learnt a great deal about public *** time the votes that they cast in such debates came to reflect their own priorities for their *** the sums that Athenian democracy spent on different activities reflected the preferences of,not politicians,as Kallet argued,but the dēmos themselves.

关键词： CLASS argument reflected