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Trustworthy evidence- based versus untrustworthy guidelines: detecting the difference

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Family Medicine and Community Health 2023年第4期11卷 85-90页

作者： joão pedro Lima Wimonchat Tangamornsuksan Gordon H Guyatt Department of Health Research Methods Evidenceand ImpactMcMaster UniversityHamiltonOntarioCanada

Guidelines are essential tools in healthcare *** guidelines inform clinicians not only on the direction(against or in favour)and strength(strong or weak/conditional)of recommendations but also on the certainty of the underlying *** trustworthy guidelines requires panellists with clinical and methodological expertise who consider patients’values and *** to trustworthiness standards remains variable;clinicians should,therefore,be able to distinguish trustworthy from untrustworthy *** this paper,we offer eight domains of disparities between trustworthy evidence-based guidelines and less trustworthy guidelines.

关键词： worthy trust lists

Modelling the role of ground-true riparian vegetation for providing regulating services in a Mediterranean watershed

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International Soil and Water Conservation Research 2023年第1期11卷 159-168页

作者： Bruno A.Aparício joão pedro Nunes Léonard Bernard-Jannin Luis Filipe Dias Andre Fonseca Teresa Ferreira cE3c-Centre for Ecology Evolution and Environmental Changes&CHANGE-Global Change and Sustainability InstituteFaculty of SciencesUniversity of LisbonLisbonPortugal Forest Research Centre&Laboratory TERRA School of AgricultureUniversity of LisbonLisbonPortugal Soil Physics and Land Management Group Wageningen University and ResearchWageningenNetherlands Longline Environment Ltd LondonUK

Intensive agricultural and industrial activities are often considered major sources of water ***,riparian vegetation(RV)is increasingly being promoted as a solution to balance the potentially adverse effects that agriculture may have on water ***,existing RV is often overlook in recent modelling efforts,failing to capture the current amount of ecosystem services ***,we used the Soil and Water Assessment Tool ecohydrological model to simulate the influence of ground-true RV on i)nutrient(nitrate and total phosphorus)and sediment exports from agricultural areas and ii)its effect for in-stream *** results are further compared against a set of hypothetical scenarios of different RV widths and different *** results point to a great rele-vance of existing RV in controlling in-stream concentration of sediments and nutrients where pressure from agriculture is highest,preventing them to surpass limits set in the EU Water Framework *** the other hand,in areas with industry discharges,the role of RV is limited and model results suggest that restoring RV would have limited *** illustrate how existing RV may already provide strong but not acknowledged water quality regulation services,how these services can differ substantially between nearby streams,and that effective strategies to improve water quality using RV must acknowledge existing patterns of vegetation,land use and contamination sources.

关键词： Agricultural pollution Riparian vegetation Ecosystem services Hydrological services Mediterranean region

Dexamethasone intravitreal implant(ozurdex) in diabetic macular edema: real-world data versus clinical trials outcomes

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International journal of ophthalmology(English edition) 2021年第10期14卷 1571-1580页

作者： pedro Neves Mário ornelas Inês Matias joão Rodrigues Margarida Santos Marco DutraMedeiros David Martins Department of ophthalmology Centro Hospitalar de SetúbalSetúbal 2910-549Portugal Department of ophthalmology Hospital BeatrizÂngeloLoures 2674-514Portugal Department of ophthalmology Hospital da Luz SetúbalSetúbal 2900-722Portugal Department of ophthalmology Centro Hospitalar Lisboa CentralFaculdade de Ciências MédicasNOVA University of LisbonLisbon 1990-237Portugal

AIM: To investigate the safety and efficacy of intravitreal dexamethasone implants(ozurdex?/DEX) in patients with diabetic macular edema(DME) either na?ve or nonna?ve to anti-VEGF therapies who switched to DEX implant independent of response to anti-vascular endothelial growth factors(anti-VEGFs).METHoDS: This was an audit retrospective review of medical records of patients with DME who switched to the DEX intravitreal implant. Patients were divided into 2 groups: patients na?ve to antiangiogenic therapy and patients who were previously treated with anti-VEGFs. Data regarding demographics, changes in mean best-corrected visual acuity(BCVA), central macular thickness(CMT), and intraocular pressure(IoP) was collected over 6 mo. The demographic data mean changes in BCVA, CMT, and IoP were compared. Six-month follow-up data of 47 patients(57 eyes), who either switched to DEX implant irrespective of response to previous treatments or were treatment na?ve before receiving DEX implant, was ***: Improvement in mean BCVA was observed from 1-4 mo after injection with a decreased effect at month 6 as expected, with better outcomes in na?ve compared to non-na?ve patients. A statistically relevant decrease in mean CMT was observed during the follow-up period. An increase in mean IoP was observed in the first 2 mo after DEX therapy. The mean number of injections of the overall population during the 6 mo was 1.3. A subgroup analysis showed no relevant difference between phakic versus pseudophakic patients relative to measured outcomes. There was no cataract progression during the follow-up period and no adverse events ***: This real-life setting study shows that intravitreal DEX implant is effective and safe. The timings of greater therapeutic impact are concordant with previous studies and suggest that earlier treatment with corticosteroids may have an additional benefit in na?ve patients.

关键词： anti-VEGF therapy diabetic macular edema dexamethasone intravitreal implant na?ve eyes steroids

Molecular characterization of an extensively drug-resistant Acinetobacter baumannii isolated from a corn culture soil

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Pedosphere 2021年第6期31卷 973-976页

作者： joao pedro Rueda FURLAN Eliana Guedes STEHLING Departamento de Analises Clinicas Toxicologicas e BromatologicasFaculdade de CienciasFarmaceuticas de Ribeirao PretoUniversidade de Sao Paulo(USP)Ribeirao Preto SP 14040-903(Brazil)

Dear Editor,Soil is the most biodiverse habitat on Earth and it has been estimated that one gram of soil can contain up to one billion bacterial cells(Fierer,2017).The microorganisms of soil produce a wide variety of ... 详细信息

关键词： soil corn culture

Mechanical behavior of iron ore tailings under standard compression and extension triaxial stress paths

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journal of Rock Mechanics and Geotechnical Engineering 2023年第7期15卷 1883-1894页

作者： Alexia Cindy Wagner joão Paulo de Sousa Silva joão Vítor de Azambuja Carvalho Ana Luisa Cezar Rissoli pedro Pazzoto Cacciari Helder Mansur Chaves Hugo Carlos Scheuermann Filho Nilo Cesar Consoli Universidade Federal do Rio Grande do Sul Porto Alegre90035-190Brazil Mineral Development Centre Vale S.A.Santa Luzia33040-900Brazil Department of Civil Geological and Mining EngineeringPolytechnique MontrealMontrealH3C 3A7Canada

The disposal of mining tailings has increasingly focused on the use of dry *** structures offer more security since they use filtered and compacted *** of the construction method and the heights achieved,the material that compounds the structure can be subjected to different stress paths along the failure *** theoretical framework considered in the design of these structures generally is the critical state soil mechanics(CSSM).However,the data in the literature concerning the uniqueness of critical state line(CSL)is still controversial as the soil is subjected to different stress *** respect to tailings,this question is even more *** paper studies two tailings with different gradings due to the beneficial processes over extension and compression paths.A series of drained and undrained triaxial tests was conducted over a range of initial densities and stress *** the q-p'plane,different critical stress ratio(M)values were obtained for compression and extension stress ***,the critical state friction angle is very similar with a slightly higher critical state friction angle for extension *** stress path dependent CSLs were obtained in the n-lnp0 plane with the extension tests below the CSL defined in *** the fines content,the studied tailings presented very similar M and critical state friction angle ***,the fines content af-fects the volumetric behavior of the studied tailings and the CSLs on the n-lnp0 plane shift downwards with the increasing fines content for compression and extension *** relation to dilatancy analysis,the fines content did not present an evident influence on the dilatancy of the ***,different values of mean stress ratio N were obtained between compression and extension tests and can corroborate the existence of non-unique CSLs for these materials.

关键词： Iron ore tailings(IoTs) Dry stacking Critical state soil mechanics Extension tests Stress path

Acute diverticulitis in younger patients:Any rationale for a different approach?

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World journal of Gastroenterology 2011年第2期17卷 207-212页

作者： Gil R Faria Ana B Almeida Herculano Moreira joo Pinto-de-Sousa pedro Correia-da-Silva Amadeu P Pimenta Department of General Surgery Hospital de So Joo Faculty of Medicine of the University of Porto Institute of Pathology and Molecular Immunology of the University of Porto-IPATIMUP-Rua Dr.Roberto Frias s/n 4200-465 PortoPortugalPortoPortugal Institute of Pathology and Molecular Immunology of the University of Porto-IPATIMUP-Rua Dr.Roberto Frias s/n 4200-465 PortoPortugal

AIM:To compare the natural history and course of acute diverticulitis in a younger age group with an older population and to evaluate whether younger patients should be managed differently. METHoDS:This study was a retrospective review of 157 patients treated with acute diverticulitis between January 1,2004 and December 31,*** was stratified according to the Hinchey classification. Patients were divided into 2 populations:group A≤ 50 years(n=31) ;group B>50 years(n=126) .Mean patient follow-up was 15 mo. RESULTS:The median age was 60 years.A significantly higher proportion of patients in group B presented with complicated diverticulitis(36.5%vs 12.9%,P=0.01) .Recurrence was more frequent in group A(25.8%vs 11.1%,P=0.03) and the mean time-torecurrence was shorter(12 mo vs 28 mo,P=0.26) . The most severe recurrent episodes of acute diverticulitis were classified as Hinchey stageⅠand none of the patients required emergency *** multivariate analysis,only age(P=0.024) was identified as an independent prognostic factor for recurrence. CoNCLUSIoN:Based on the results of this study,we recommend that diverticulitis management should be based on the severity of the disease and not on the age of the patient.

关键词： Acute diverticulitis Recurrence Age factors Severity Surgical treatment

Abiotic stress on seed germination and plant growth of Zeyheria tuberculosa

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林业研究:英文版 2023年第5期34卷 1511-1522页

作者： Robson Luis Silva de Medeiros Rinaldo Cesar de Paula joao Vitor oliveira de Souza joao pedro Peixoto Fernandes Department of Agricultural Sciences School of Agricultural and Veterinarian SciencesSao Paulo State University(Unesp)14884-900JaboticabalSao PauloBrazil

Zeyheria tuberculosa(Vell.)Bureau ex *** among the Brazilian flora threatened with *** has high-quality wood and can be used to recover herbicidecontaminated ***,abiotic stresses can harm seed germination and seedling development under adverse conditions and need to be understood to improve autochthonous or indigenous biodiversity conservation and strengthen reforestation *** study evaluated the effects of temperature,water and saline stress on *** seed germination and water stress on seedling *** laboratory experiments evaluated germination under:(1)different temperatures(20,25,30,35 and 40℃);(2)different water potentials simulated with polyethylene glycol(PEG6000)at 25 and 30℃;and,(3)different osmotic potentials simulated with NaCl at 25 and 30℃.In addition,a greenhouse experiment subjected seedlings to five water regimes(20%,35%,50%,65%and 80%of maximum substrate water holding capacity).In the laboratory,seedling biometry and germination were evaluated,while physiological and morphological parameters were assessed in the *** potential of seeds increased at 25 and 30℃.Germination and vigor decreased as water and saline stresses *** tolerance thresholds for water and salt stresses were-0.6 and-0.4 MPa,*** the greenhouse,the most restrictive water regimes reduced seedling physiological and morphological *** development was compromised at moisture levels below50%field capacity.

关键词： Bignoniaceae Climate change Ipê-felpudo Ipê-preto Water stress

Hyperbaric oxygen therapy as a complementary treatment for radiation proctitis:Useless or useful?-A literature review

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World journal of Gastroenterology 2021年第27期27卷 4413-4428页

作者： Diogo Alpuim Costa Carla Espiney Amaro Ana Nunes joana Santos Cardoso pedro Modas Daniel Isabel Rosa joão Vieira Branco Department of Haematology and oncology CUF OncologiaLisboa 1998-018Portugal Centro de Medicina Subaquática e Hiperbárica(CMSH) Portuguese NavyLisboa 1649-020Portugal Centro de Investigação Naval(CINAV) Portuguese NavyBase Naval do AlfeiteAlmada 2810-001Portugal oVA Medical School Faculdade de Ciências MédicasLisboa 1169-056Portugal Department of otorhinolaryngology Hospital das Forças Armadas(HFAR)Lisboa 1649-020Portugal Department of Gastroenterology Hospital das Forças Armadas(HFAR)Lisboa 1649-020Portugal Department of Vascular Surgery Centro Hospitalar Universitário de Lisboa CentralHospital de Santa MartaLisboa 1169-024Portugal Department of Intensive Care Unit Hospital das Forças Armadas(HFAR)Lisboa 1649-020Portugal Department of General Surgery Hospital das Forças Armadas(HFAR)Lisboa 1649-020Portugal

Radiotherapy(RT)is the backbone of multimodality treatment of more than half of cancer *** new modern RT techniques,late complications may occur such as radiation proctitis(RP).The natural history of RP is *** symptoms may resolve spontaneously or require conservative *** the other hand,for similar and uncomplicated clinical contexts,symptoms may persist and can even be refractory to the progressive increase in treatment *** the last decades,an enormous therapeutic armamentarium has been considered in RP,including hyperbaric oxygen therapy(HBoT).Currently,the evidence regarding the impact of HBoT on RP and its benefits is *** prospective and randomised studies are necessary to validate HBoT’s effectiveness in the‘real world’clinical *** article reviewed the relevant literature on pathophysiology,clinical presentation,different classifications and discuss RP management including a proposal for a therapeutic algorithm with a focus on HBoT.

关键词： Radiation proctitis Radiation proctopathy Radiotherapy Radio-induced lesion Late radiation tissue injury Delayed radiation injury Late sequelae Hyperbaric oxygen therapy Hyperbaric oxygen Review

Ion dynamics into different pore size distributions in supercapacitors under compression

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journal of Energy Chemistry 2023年第5期80卷 110-119,I0004页

作者： joão pedro Aguiar dos Santos Cesar J.B.Pagan Rafael Vicentini Reinaldo F.Teófilo Renato Beraldo Leonardo M.Da Silva Hudson Zanin Brazilian Renewable Energies Center for Innovation on New EnergiesSchool of Electrical and Computer EngineeringUniversity of CampinasAv.Albert Einstein 40CampinasSP13083-852Brazil School of Electrical and Computer Engineering University of CampinasSP 13083-852Brazil Multivariate Chemical Data Analysis Laboratory Department of ChemistryUniversidade Federal de Viçosa36570-900 ViçosaMGBrazil Department of Chemistry Laboratory of Fundamental and Applied ElectrochemistryFederal University of Jequitinhonha and Mucuri's ValleyRodovia MGT 367km 5835000 Alto da Jacuba39100-000DiamantinaMGBrazil

Compressing supercapacitor(SCs)electrode is essential for improving the energy storage characteristics and minimizing ions’distance travel,faradaic reactions,and overall ohmic *** comprising the ion dynamics in SC electrodes under compression are still ***,the ionic dynamics of five aqueous electrolytes in electrodes under compression were studied in this work for tracking electrochemical and structural changes under mechanical stress.A superionic state is formed when the electrode is compressed until the micropores match the dimensions with the electrolyte’s hydrated ion sizes,which increases the *** excessive compression is applied,the accessible pore regions decrease,and the capacitance ***,as the studied hydrated ions have different dimensions,the match between ion/pore sizes *** the LioH and NaClo4electrolytes,increasing the pressure from 60 to 120 and 100 PSI raised the capacitance from 13.5 to 35.2 F g^(-1)and 30.9 to 39.0 F g^(-1),***,the KoH electrolyte with the lowest and LiCl with the biggest combination of hydrated ion size have their point of maximum capacitance(39.5 and 36.7F g^(-1))achieved at 140 and 80 PSI,*** LiCl and KCl electrolytes,overcompression causes a drop in capacitance higher than 23%.

关键词： Mechanic compression Pore size distribution lon dynamics Activated carbon Supercapacitors