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Functional lumen imaging probe use in a high-volume practice:Practical and technical implications

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World Journal of Gastrointestinal Endoscopy 2024年第7期16卷 396-405页

作者： Yan Jiang Raul Vazquez-Reyes Afrin Kamal Thomas Zikos George Triadafilopoulos john O clarke Division of Gastroenterology and Hepatology Stanford University School of MedicineRedwoodCA 94063United States

BACKGROUND The functional lumen imaging probe(FLIP)is a Food and Drug Administration approved tool to aid the diagnosis and management of esophageal ***,widespread adoption of FLIP remains limited and its utility in highvolume practices remains *** To analyze large sample data on clinical use of FLIP and provide insight on several technical aspects when performing *** We conducted a retrospective comparative and descriptive analysis of FLIP procedures performed by a single provider at an academic medical *** was a total of 398 FLIP procedures *** medical records were reviewed and data regarding demographics and procedural details were *** tests,including chi-squared,t-test,and multivariable logistic and linear regression,were *** There was an increase in FLIP cases with each successive time period of 13 months(n=68,146,184,respectively)with notable rises specifically for indications of dysphagia and gastroesophageal reflux *** was a shift toward use of the longer FLIP balloon catheter for diagnostic purposes(overall 70.4%vs 29.6%,P<0.01).Many cases(42.8%)were performed in conjunction with other diagnostics/interventions,such as dilation and wireless pH probe *** were nearly equally performed with anesthesia vs moderate sedation(51.4%anesthesia),with no major *** who had anesthesia were less likely to have recurrent antegrade contractions[odds ratio(OR)=0.4,95%CI:0.3-0.8]and were also more likely to have absent contractility(OR=2.4,95%CI:1.3-CONCLUSION FLIP cases have increased in our practice with expanding indications for its *** limited normative data,providers should be aware of several potential technical issues,including the possible impact of sedation choice when assessing esophageal motility patterns.

关键词： Gastroenterology Endoscopy Functional lumen imaging probe Esophagus Motility

Storylines of family medicine Ⅲ:core principles—primary care,systems and family

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Family Medicine and Community Health 2024年第S3期12卷 23-32页

作者： William B Ventres Leslie A Stone Timothy A Joslin john W Saultz Sommer Aldulaimi paul R Gordon john C Lane Eric R Lee Jacob Prunuske Limor Gildenblatt Michael H Friedman Colleen T Fogarty Susan H McDaniel Tessa Rohrberg Amy Odom Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family Medicine Oregon Health&Science UniversityPortlandOregonUSA Family and Community Medicine University of Arizona Medical Center–South CampusTucsonArizonaUSA Family and Community Medicine University of Arizona Medical Center–University CampusTucsonArizonaUSA UAMS West Regional Campus Family Medicine Residency Program Fort SmithArkansasUSA Medical College of Wisconsin–Central Wisconsin Campus WausauWisconsinUSA Family and Community Medicine Medical College of Wisconsin–Central Wisconsin CampusWausauWisconsinUSA Family Medicine Advocate Illinois Masonic Medical CenterChicagoIllinoisUSA Family Medicine Presence Saints Mary and Elizabeth Medical CenterChicagoIllinoisUSA Family Medicine University of Rochester Medical CenterRochesterNew YorkUSA Psychiatry and Family Medicine University of Rochester Medical CenterRochesterNew YorkUSA Family and Community Medicine University of Kansas School of Medicine-WichitaWichitaKansasUSA Sparrow/Michigan State University Family Medicine Residency Program LansingMichiganUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅲ:core principles—primary care,systems,and family’,authors address the following themes:‘Continuity of care—building therapeutic relationships over time’,‘Comprehensiveness—combining breadth and depth of scope’,‘Coordination of care—managing multiple realities’,‘Access to care—intersectional,systemic,and personal’,‘Systems theory—a core value in patient-centered care’,‘Family-oriented practice—supporting patients’health and well-being’,‘Family physician as family member’and‘Family in the exam room’.May readers develop new understandings from these essays.

关键词： individual Storyline principles

Patients’experiences with‘sludge’(administrative burden)in the cancer screening process and its relationship with screening completion,experience and health system distrust

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Family Medicine and Community Health 2024年第S2期12卷 8-17页

作者： Michelle S Rockwell Brianna Chang Vivian Zagarese Jamie K Turner Ally Southworth YingXing Wu paul Yeaton Li Li Jeffrey S Stein Sarah H Parker john W Epling Department of Family and Community Medicine Virginia Tech Carilion School of MedicineRoanokeVirginiaUSA Department of Family and Community Medicine Carilion ClinicRoanokeVirginiaUSA Virginia Tech Carilion School of Medicine RoanokeVirginiaUSA Department of Health Systems and Implementation Science Virginia Tech Carilion School of MedicineRoanokeVirginiaUSA Graduate Program in Translational Biology Medicineand HealthVirginia TechRoanokeVirginiaUSA Health Analytics Research Team Carilion ClinicRoanokeVirginiaUSA Division of Gastroenterology Department of Internal MedicineCarilion ClinicRoanokeVirginiaUSA Department of Family Medicine University of Virginia School of MedicineCharlottesvilleVirginiaUSA Center for Health Behaviors Research Fralin Biomedical Research Institute at VTCRoanokeVirginiaUSA

Objective‘Sludge’refers to administrative burdens or frictions that preclude people from getting what they want or need(eg,duplicative forms,complicated instructions,long waiting times).This mixed methods study evaluated patients’perceptions of sludge in the colorectal cancer(CRC)screening process and some impacts of this *** We employed an exploratory sequential mixed methods study design that comprised patient interviews and a patient *** interviews informed final survey revisions and captured contextual data about patients’experiences with *** transcripts were inductively and deductively analysed to identify overarching *** survey quantified sludge,delayed or forgone screenings,screening experience(Net Promoter Score)and health system distrust(Health System Distrust Scale).We usedχ2 or t-tests for univariable comparisons and logistic or linear regressions to evaluate the association between cumulative sludge score and delayed or forgone screenings,screening experience and health system *** were integrated for *** Southeastern United *** Patients who were 45–75 years of age,at average risk for CRC and had either completed or been referred for CRC screening(colonoscopy or stool-based test)within the previous 12 *** 22 interview participants and 255 survey participants completed the study.38(15%)survey participants rated their screening experience as poor(Net Promoter Score=0–7 out of 10).The mean(SD)Health System Distrust Scale score was 22.4(6.3)out of 45 possible points(higher score=greater distrust).Perceptions of sludge in the CRC screening process varied,with long waiting times and burdensome communication being the most common sources(58%and 35%of participants,respectively).Sludge was positively associated with delayed or forgone screenings(OR=1.42,95%CI 1.28,1.57,p<0.001),poor screening experience(OR=1.15,95%CI 1.04,1.28,p=0.009)and health system distrust(β=0.47,p

关键词： sludge screening burden

Irritable bowel syndrome: A microbiome-gut-brain axis disorder?

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World Journal of Gastroenterology 2014年第39期20卷 14105-14125页

作者： paul J Kennedy john F Cryan Timothy G Dinan Gerard clarke 1.15 Biosciences Institute Department of Psychiatry Alimentary Pharmabiotic Centre University College Cork Cork Ireland Department of Anatomy and Neuroscience Alimentary Pharmabiotic CentreUniversity College CorkCork Ireland

Irritable bowel syndrome(IBS) is an extremely prevalent but poorly understood gastrointestinal disorder. Consequently, there are no clear diagnostic markers to help diagnose the disorder and treatment options are limited to management of the symptoms. The concept of a dysregulated gut-brain axis has been adopted as a suitable model for the disorder. The gut microbiome may play an important role in the onset and exacerbation of symptoms in the disorder and has been extensively studied in this context. Although a causal role cannot yet be inferred from the clinical studies which have attempted to characterise the gut microbiota in IBS, they do confirm alterations in both community stability and diversity. Moreover, it has been reliably demonstrated that manipulation of the microbiota can influence the key symptoms, including abdominal pain and bowel habit, and other prominent features of IBS. A variety of strategies have been taken to study these interactions, including probiotics, antibiotics, faecal transplantations and the use of germ-free animals. There are clear mechanisms through which the microbiota can produce these effects, both humoral and neural. Taken together, these findings firmly establish the microbiota as a critical node in the gut-brain axis and one which is amenable to therapeutic interventions.

关键词： Irritable bowel syndrome Microbiome Anxiety Tryptophan Abdominal pain Gastrointestinal motility Cognition

An improved culturing method for opiine fruit fly parasitoids and its application to parasitoid monitoring in the field

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Insect Science 2018年第1期25卷 99-108页

作者： Ayad Masry Michael J. Furlong Anthony R. clarke john paul Cunningham School of Earth Environmental and Biological Sciences School Queensland University of Technology (QUT) Brisbane Queensland Australia School of Biological Sciences the University of Queensland St Lucia Queensland Australia plant Biosecurity Cooperative Research Centre Bruce ACT Australia Department of Economic Development Jobs Transport and Resources AgriBio Centre La Trobe University Bundoora Victoria Australia

Good culturing methods play an important role in the study of insect behavior and its application to pest management. Here, we describe and validate a new method for rearing the parasitoid wasp, Diachasmirnorpha kraussii, which attacks some of the world＇s worst fruit fly pests and is an internationally used biological control agent. Our method differs from standard culturing approaches by presenting adult wasps with host- infested artificial media within a ＂culturing bag,＂ which mimics a natural （fruit） oviposition substrate. In laboratory trials using wild collected D. kraussii, the culturing bag method was compared to the use of host-infested nectarines, and a commonly used laboratory method of presenting host-infested artificial media within Petri dishes. The culturing bag method proved to be a significant improvement on both methods, combining the advantages of high host survival in artificial media with parasitism levels that were the equivalent to those recorded using host-infested fruits. In our field study, culturing bags infested with the Queensland fruit fly, Bactrocera tryoni, and hung in a mixed peach and nectarine orchard proved to be effective ＂artificial fruits＂ attracting wild D. kraussii for oviposition. Significantly more adult wasps were reared from the culturing bags compared to field collected fruits. This was shown to be due to higher fruit fly larval density in the bags, as similar percentage parasitism rates were found between the culturing bags and ripe fruits. We discuss how this cheap, time-efficient method could be applied to collecting and monitoring wild D. kraussii populations in orchards, and assist in maintaining genetic variability in parasitoid laboratory cultures.

关键词： Bactrocera biological control fruit fly mass rearing natural enemies Tephritidae wasp

Storylines of family medicine Ⅻ:family medicine and the healthcare system

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Family Medicine and Community Health 2024年第S3期12卷 109-118页

作者： William B Ventres Leslie A Stone Jeannette E South-paul Kendall M Campbell Aerial R Petty Hima Ekanadham Kurt C Stange Rebecca S Etz William L Miller Robert L Ferrer Marianna Kong Thomas Bodenheimer Roger Strasser Sharon C M Reece Joshua Freeman john M Westfall Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Meharry Medical College NashvilleTennesseeUSA Family Medicine University of Texas Medical Branch at Galveston School of MedicineGalvestonTexasUSA Family Medicine Residency Program New York-Presbyterian Columbia University Medical CenterNew YorkNew YorkUSA Center for Family and Community Medicine Columbia University Vagelos College of Physicians and SurgeonsNew YorkNew YorkUSA Center for Community Health Integration Case Western Reserve University School of MedicineClevelandOhioUSA Family Medicine and Population Health Virginia Commonwealth University School of MedicineRichmondVirginiaUSA Family Medicine Lehigh Valley Health NetworkAllentownPennsylvaniaUSA University of South Florida Morsani College of Medicine TampaFloridaUSA Family and Community Medicine UT Health San Antonio Long School of MedicineSan AntonioTexasUSA Family and Community Medicine University of California San Francisco School of MedicineSan FranciscoCaliforniaUSA Northern Ontario School of Medicine University SudburyOntarioCanada Family Medicine Baylor Scott and White HealthTempleTexasUSA Family Medicine University of Kansas School of MedicineKansas CityKansasUSA DARTNet Insitute AuroraColoradoUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅻ:Family medicine and the future of the healthcare system’,authors address the following themes:‘Leadership in family medicine’,‘Becoming an academic family physician’,‘Advocare—our call to act’,‘The paradox of primary care and three simple rules’,‘The quadruple aim—melding the patient and the health system’,‘Fit-for-purpose medical workforce’,‘Universal healthcare—coverage for all’,‘The futures of family medicine’and‘The 100th essay.’May readers of these essays feel empowered to be part of family medicine’s exciting future.

关键词： system illustration family

Quantitative Applications of Weather Satellite Data for Nowcasting:Progress and Challenges

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Journal of Meteorological Research 2024年第3期38卷 399-413页

作者： Jun LI Jing ZHENG Bo LI Min MIN Yanan LIU Chian-Yi LIU Zhenglong LI Wpaul MENZEL Timothy J.SCHMIT john L.CINTINEO Scott LINDSTROM Scott BACHMEIER Yunheng XUE Yayu MA Di DI Han LIN Innovation Centre for Fengyun Meteorological Satellite(FYSIC) National Satellite Meteorological CentreChina Meteorological AdministrationBeijing100081China School of Atmospheric Sciences and Guangdong Province Key Laboratory for Climate Change and Natural Disaster Studies Sun Yat-sen University and Southern Laboratory of Ocean Science and EngineeringZhuhai519082China Key Laboratory of Geographic Information Science(Ministry of Education) East China Normal UniversityShanghai200241China Research Center for Environmental Changes Academia SinicaTaipei11529China Cooperative Institute for Meteorological Satellite Studies University of Wisconsin-MadisonMadisonWI53706USA Sensors and Calibration Branch STAR/NESDISMadisonWI53706USA Wuxi University Wuxi214105China School of Computer Science Chengdu University of Information TechnologyChengdu610225China Collaborative Innovation Center on Forecast and Evaluation of Meteorological Disasters Nanjing University of Information Science&TechnologyNanjing210044China Key Laboratory of Spatial Data Mining and Information Sharing of Ministry of Education National and Local Joint Engineering Research Center of Satellite Geospatial Information TechnologyFuzhou UniversityFuzhou350108China

Monitoring and predicting highly localized weather events over a very short-term period,typically ranging from minutes to a few hours,are very important for decision makers and public *** these events usually relies on radar observations through monitoring and *** advanced high-resolution imaging and sounding observations from weather satellites,nowcasting can be enhanced by combining radar,satellite,and other data,while quantitative applications of those data for nowcasting are advanced through using machine learning *** applications include monitoring the location,impact area,intensity,water vapor,atmospheric instability,precipitation,physical properties,and optical properties of the severe storm at different stages(pre-convection,initiation,development,and decaying),identification of storm types(wind,snow,hail,etc.),and predicting the occurrence and evolution of the *** observations can provide information on the environmental characteristics in the preconvection stage and are very useful for situational awareness and storm *** paper provides an overview of recent progress on quantitative applications of satellite data in nowcasting and its challenges,and future perspectives are also addressed and discussed.

关键词： weather satellite quantitative applications nowcasting pre-convection

The Decarbonization of Construction—How Can Alkali-Activated Materials Contribute?

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Engineering 2024年第6期37卷 18-21页

作者： john L.Provis Susan A.Bernal Zuhua Zhang Department of Materials Science and Engineering University of SheffieldSheffield S13JDUK paul Scherrer Institut Villigen PSI 5232Switzerland School of Civil Engineering University of LeedsLeeds LS29JTUK School of Materials Sciences and Engineering Tongji UniversityShanghai 201804China

*** and context Enormous emphasis is currently being paid to the decarbonization of the global built environment as a leading priority for the engineering community and related industrial sectors[1].One of the main contributors to the overall emissions footprint of the built environment-and thus a cornerstone of efforts to achieve decarbonization-is the emissions profile of construction materials during their production and *** cement and concrete sector is the largest-volume contributor to the emissions incurred in meeting the world’s construction material needs and is therefore targeted in the discussion of the deep,rapid decarbonization that must be achieved in order to minimize irreversible damage to the Earth and its ecosystems.

关键词： Alkali corners irreversible

From laboratory to the field: consistent effects of experience on host location by the fruit fly parasitoid Diachasmimorpha kraussii (Hymenoptera: Braconidae)

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Insect Science 2019年第5期26卷 863-872页

作者： Ayad Masry john P.Cunningham Anthony R.clarke School of Earth Environmental and Biological SciencesQueensland University of Technology (QUT)BrisbaneQueenslandAustralia Agriculture Victoria Research AgilBioCentre for AgriBioscienceBundooraVictoriaAustralia

Associative learning is well documented in Hymenopteran parasitoids, where it is thought to be an adaptive mechanism for increasing successful host location in complex environments. Based on this learning capacity, it has been suggested that providing prerelease training to parasitoids reared for inundative release may lead to a subsequent increase in their efficacy as biological control agents. Using the fruit fly parasitoid Diachasmimorpha krausii we tested this hypothesis in a series of associative learning experiments which involved the parasitoid, two host fruits (tomatoes and nectarine), and one host fly (Bactrocera ttyoni). In sequential Y-tube olfactometer studies, large field-cage studies, and then open field studies, naive wasps showed a consistent preference for nectarines over tomatoes. The preference for nectarines was retained, but not significantly increased, for wasps which had prior training exposure to nectarines. However, and again consistently at all three spatial scales, prior experience on tomatoes led to significantly increased attraction to this fruit by tomato-trained wasps, including those liberated freely in the environment. These results, showing consistency of learning at multiple spatial scales, gives confidence to the many laboratory-based learning studies which are extrapolated to the field without testing. The experiment also provides direct experimental support for the proposed practice of enhancing the quality of inundatively released parasitoids through associative learning.

关键词： biological control inundative release learning mass rearing Opiinae Tephritidae