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Diverticulitis is a population health problem:Lessons and gaps in strategies to implement and improve contemporary care

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World Journal of Gastrointestinal Surgery 2023年第6期15卷 1007-1019页

作者： Stephanie Lee Stovall Jennifer A kaplan joanna k law David R Flum Vlad V Simianu Department of Surgery Virginia Mason Franciscan HealthSeattleWA 98101United States Department of Gastroenterology Virginia Mason Franciscan HealthSeattleWA 98101United States Department of Surgery University of Washington MedicalSeattleWA 98195United States

The disease burden of diverticulitis is high across inpatient and outpatient settings,and the prevalence of diverticulitis has ***,patients with acute diverticulitis were admitted routinely for intravenous antibiotics and many had urgent surgery with colostomy or elective surgery after only a few *** recent studies have challenged the standards of how acute and recurrent diverticulitis are managed,and many clinical practice guidelines(CPGs)have pivoted to recommend outpatient management and individualized decisions about *** the rates of diverticulitis hospitalizations and operations are increasing in the United States,suggesting there is a disconnect from or delay in adoption of CPGs across the spectrum of diverticular *** this review,we propose approaching diverticulitis care from a population level to understand the gaps between contemporary studies and real-world practice and suggest strategies to implement and improve future care.

关键词： Diverticulitis Hospitalization Elective Emergent surgery Clinical guidelines Diverticular disease

Measures of intracranial compartments in acute intracerebral haemorrhage:data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial(RIGHT-2)

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Stroke & Vascular Neurology 2023年第2期8卷 151-160页

作者： kailash krishnan Zhe kang law Lisa J Woodhouse Rob A Dineen Nikola Sprigg joanna M Wardlaw Philip M Bath Stroke Department of Acute MedicineNottingham University Hospitals NHS TrustNottinghamUK Stroke Trials Unit University of NottinghamNottinghamUK Department of Medicine National University of Malaysia Faculty of MedicineKuala LumpurMalaysia Radiological Sciences Research Group University of NottinghamNottinghamUK National Institute of Health Research Nottingham Biomedical Research Centre University of NottinghamNottinghamUK Centre for Clinical Brain Sciences UK Dementia Research InstituteChancellor's BuildingUniversity of EdinburghEdinburghUK

Background and purpose Intracerebral haemorrhage volume(ICHV)is prognostically important but does not account for intracranial volume(ICV)and cerebral parenchymal volume(CPV).We assessed measures of intracranial compartments in acute ICH using computerised tomography scans and whether ICHV/ICV and ICHV/CPV predict functional *** also assessed if cistern effacement,midline shift,old infarcts,leukoaraiosis and brain atrophy were associated with *** Data from 133 participants from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial trial were *** included ICHV(using ABC/2)and ICV(XYZ/2)(by independent observers);ICHV,ICV and CPV(semiautomated segmentation,SAS);atrophy(intercaudate distance,ICD,Sylvian fissure ratio,SFR);midline shift;leukoaraiosis and cistern effacement(visual assessment).The effects of these measures on death at day 4 and poor functional outcome at day 90(modified Rankin scale,mRS of>3)was *** ICV was significantly different between XYZ and SAS:mean(SD)of 1357(219)vs 1420(196),mean difference(MD)62 mL(pkoaraiosis and cistern score(all interclass correlations,n=10:interobserver 0.72-0.99,intraobserver 0.73-1.00).ICHV/ICV and ICHV/CPV were significantly associated with mRS at day 90,death at day 4 and acute neurological deterioration(all pkoaraiosis and brain atrophy were *** Intracranial compartment measures and visual estimates are *** adjusted for ICH and CPV could be useful to prognosticate in acute *** presence of midline shift and cistern effacement may predict outcome but the mechanisms need validation in larger studies.

关键词： measures Tri nitrate

Factors associated with incomplete small bowel capsule endoscopy studies

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World Journal of Gastroenterology 2010年第42期16卷 5329-5333页

作者： Mitchell M Lee Andrew Jacques Eric Lam Ricky kwok Pardis Lakzadeh Ajit Sandhar Brandon Segal Sigrid Svarta joanna law Robert Enns St Paul's Hospital University of British Columbia770-1190 Hornby StreetVancouverBritish Columbia V6Z 2K5Canada

AIM:To identify patient risk factors associated with incomplete small bowel capsule endoscopy(CE) ***:Data from all CE procedures performed at ***'s Hospital in Vancouver,British Columbia,Canada,between December 2001 and June 2008 were collected and analyzed on a retrospective *** collection for complete and incomplete CE study groups included patient demographics as well as a number of potential risk factors for incomplete CE including indication for the procedure,hospitalization,diabetes mellitus with or without end organ damage,limitations in mobility,renal insufficiency,past history of bowel obstruction,abdominal surgery,abdominal radiation therapy and opiate *** factors were analyzed using a univariable and multivariable logistic regression ***:From a total of 535 CE procedures performed,158 were incomplete(29.5%).The univariable analysis showed that CE procedures performed for overt gastrointestinal bleeding(P = 0.002),and for patients with a prior history of abdominal surgery(P = 0.023) or bowel obstruction(P = 0.023) were significantly associated with incomplete CE *** on opiate medications(P = 0.094) as well as hospitalized patients(P = 0.054) were not statistically significant,but did show a trend towards incomplete *** multivariable analysis showed that independent risk factors for an incomplete CE procedure include prior history of bowel obstruction [odds ratios(OR) 2.77,P = 0.02,95% confidence intervals(CI):1.17-6.56] and procedures performed for gastrointestinal bleeding(Occult OR 2.04,P = 0.037,95% CI:1.04-4.02 and Overt OR 2.69,P = 0.002,95% CI:1.44-5.05).Patients with a prior history of abdominal surgery(OR 1.46,P = 0.068,95% CI:0.97-2.19),those taking opiate medications(OR 1.54,P = 0.15,95% CI:0.86-2.76) and hospitalized patients(OR 1.82,P = 0.124,95% CI:0.85-3.93) showed a trend towards statistical ***:We have identified a number of risk factors for incomplete CE procedures

关键词： Capsule Capsule endoscopy Incomplete endoscopy

Renewable Energy Legislation in China:Politicaland Institutional Strategy for EffectiveImplementation

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Chinese Journal of Population,Resources and Environment 2004年第1期2卷 13-17页

作者： joanna Lewis China Energy Group Environmental Energy Technologies DivisionLawrence Berkeley National Laboratory California94720USA

Over the past decade, the Chinese government has developed several plans regulations and policy measures related to the development of renewable energy technologies and has implemented a series of pilot projects. Chinese policymakers have spent several years studying how renewable energy policy models that have been used internationally could be implemented in China. Programs are currently underway to implement pilot renewable portfolio standards, or mandatory market shares (MMS) for renewable energy, in several provinces. This paper examines the primary institutions that are involved in promoting renewable policies in China, the structure of the policies that currently are being drafted, and the status of the complementary, national-level renewable energy law being drafted to provide a legal basis for ongoing local and national-level policies. It then examines the legal requirements for promoting renewable energy legislation under the Chinese law-making system. Finally, it provides recommendations

关键词： Renewable Energy Mandatory Market Share Energy Legislation

Examination of Possible Flow Turbulence during Flow-Mediated Dilation Testing

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Open Journal of Medical Imaging 2011年第1期1卷 1-8页

作者： Lee Stoner Manning Joseph Sabatier joanna Mary Young Lipid and Diabetes Research Group Diabetes Research Institute Department of kinesiology University of Georgia Division of Biological Sciences Clayton State University

The validity of the flow-mediated dilation (FMD) test has been doubted due to the lack of normalization to the primary stimulus, shear stress. Shear stress can be calculated using a simplified mathematical model based on Poiseuille’s law. Poiseuille’s law assumes that the blood velocity profile is parabolic. The presence of turbulence will violate this assumption. The Reynolds number (RE) is used to define critical values for the transition from laminar to turbulent flow. Between RE values of 2000 and 4000, flow enters a transitional phase where turbulence is possible. Purpose: To determine whether brachial artery blood flow becomes turbulent during reactive hyperemia following forearm ischemia. Methods: Eleven healthy male subjects (25 ± 5 years) were tested. Brachial artery diameters and blood velocities were measured continuously following 2, 4, 6 and 10 minutes ischemia. The peak post-ischemic RE (REpeak) and RE integrated over 40 seconds (RE40) post-ischemia were calculated. Results: There was a significant change in REpeak (F4,7 = 98.573, p = ≤ 0.001) and RE40) (F4,7) = 50.613, p = ≤ 0.001) in response to ischemia. Within-subjects contrasts revealed a significant increase in REpeak and RE40 for each duration of ischemia versus baseline (p = ≤ 0.001). Following 4 minutes of ischemia there was approximately 12 seconds of potentially turbulent flow. Conclusion: Blood flow transitions between laminar and turbulent flow during ischemia-induced reactive hyperemia. This may limit the efficacy of estimating shear stress when using the standard FMD test protocol.

关键词： Flow Mediated Dilatation Blood Flow Shear Stress Turbulence Reynolds Number Poiseuille’s law

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重估十九世纪中国

清史研究 2019年第1期113卷 149-156页

作者：卫周安郑旦纽约大学历史系中国人民大学清史研究所

本文是对以下著作的评论:陈利:《帝国视野中的中国法律:主权、正义与跨文化政治》(Li Chen,Chinese law in Imperial Eyes:Sovereignty,Justice,and Transcultural *** York:Columbia U.P.,2016;PP.416.)

关键词：中国法律十九世纪文化政治 law 主权陈利正义