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Delivery of essential pediatric congenital surgical care within Brazil’s universal health coverage system:a national survey of pediatric surgeons

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World Journal of Pediatric Surgery 2023年第3期6卷 136-146页

作者： Paul R Truche Abbie E Naus Fabio Botelho Julia Ferreira Alexis Bowder Luke Caddell kathrin zimmerman Isabella Maria de Freitas Faria Bellisa Caldas Lopes Eduardo Corrêa Costa Fernanda Lage Lima Dantas Augusto J S A Cavalcante Carlos A L B Carvalho Simone Abib David P Mooney Nivaldo Alonso Program in Global Surgery and Social Change Harvard Medical SchoolBostonMassachusettsUSA Department of Surgery Rutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA Department of Pediatric Surgery McGill UniversityMontrealQuébecCanada Department of Surgery Medical College of WisconsinMilwaukeeWisconsinUSA Division of Otolaryngology-Head and Neck Surgery Department of SurgeryUniversity of Wisconsin-Madison School of Medicine and Public HealthMadisonWisconsinUSA School of Medicine UFMGBelo HorizonteMinas GeraisBrazil Department of Pediatric Surgery Instituto de Medicina Integral Professor Fernando FigueiraRecifeBrazil Department of Pediatric Surgery Hospital de Clinicas de Porto AlegrePorto AlegreBrazil Department of Pediatric Surgery Federal University of AcreRio BrancoBrazil Department of Pediatric Surgery Hospital Santa Casa de Belo HorizonteBelo HorizonteBrazil Department of Pediatric Surgery Federal University of Mato GrossoCuiabaBrazil Department of Pediatric Surgery UNIFESPSao PauloBrazil Department of Pediatric Surgery Boston Children's HospitalBostonMassachusettsUSA Department of Plastic Surgery University of São Paulo Institute of Biomedical SciencesSao PauloBrazil

Objective In this study,we assess the delivery of congenital pediatric surgical care under Brazil’s system of universal health coverage and evaluate differences in delivery between public and private *** A cross-sectional national survey of pediatric surgeons in Brazil was *** were asked which of 23 interventions identified through the Disease Control Priorities 3(Surgical Interventions for Congenital Anomalies)they perform and to report barriers faced while providing surgical *** were weighted by state and stratified by sector(public vs private).Results A sample of 352 responses was obtained and weighted to represent 1378 practicing pediatric surgeons registered in Brazil during the survey time.73%spend the majority of their time working in the public sector(‘SistemaÚnico de Saúde’and Foundation hospitals),and most of them also work in the private ***,Brazilian pediatric surgeons have the expertise to provide thoracic,abdominal,and urologic *** working mostly in the public sector were more likely to report a lack of access to essential medications(25%vs 9%,p<0.01)and a lack of access to hospital beds for surgical patients(52%vs 32%,p<0.01).Conclusions Brazilian pediatric surgeons routinely perform thoracic,abdominal,and urologic *** working in government-financed hospitals face barriers related to infrastructure,which may impact Brazilians who rely on Brazil’s universal health coverage *** that support pediatric surgeons working in the public sector may promote the workforce available to provide congenital pediatric surgical care.

关键词： pediatric survey Brazil

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Inpatient management of iron deficiency anemia in pediatric patients with inflammatory bowel disease: A single center experience

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World Journal of Clinical Pediatrics 2024年第1期13卷 107-117页

作者： Krishanth Manokaran Jonathan Spaan Giulio Cataldo Christopher Lyons Paul D Mitchell Tatyana Sare LoriA zimmerman Paul A Rufo Center for Inflammatory Bowel Disease Boston Children's HospitalBostonMA 02115United States Institutional Centers for Clinical and Translational Research Boston Children's HospitalBostonMA 02115United States

BACKGROUND Screening for iron deficiency anemia(IDA)is important in managing pediatric patients with inflammatory bowel disease(IBD).Concerns related to adverse reactions may contribute to a reluctance to prescribe intravenous(IV)iron to treat IDA in this *** To track the efficacy and safety of IV iron therapy in treating IDA in pediatric IBD patients admitted to our *** A longitudinal observational cohort study was performed on 236 consecutive pediatric patients admitted to our tertiary IBD care center between September 2017 and December 2019.92 patients met study criteria for IDA,of which 57 received IV iron,17 received oral iron,and 18 were discharged prior to receiving iron *** Patients treated with IV iron during their hospitalization experienced a significant increase of 1.9(±0.2)g/dL in mean(±SE)hemoglobin(Hb)concentration by the first ambulatory follow-up,compared to patients who received oral iron 0.8(±0.3)g/dL or no iron 0.8(±0.3)g/dL(P=0.03).One out of 57(1.8%)patients that received IV iron therapy experienced an adverse *** Our findings demonstrate that treatment with IV iron therapy is safe and efficacious in improving Hb and iron levels in pediatric patients with IDA and active IBD.

关键词： Iron deficiency anemia Pediatric inflammatory bowel disease Intravenous iron therapy Inflammatory bowel disease

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Biological transformation,kinetics and dose-response assessments of bound musk ketone hemoglobin adducts in rainbow trout as biomarkers of environmental exposure

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Journal of Environmental Sciences 2008年第7期20卷 878-884页

作者： M A Mottaleb J H zimmerman T W Moy Department of Chemistry and Biochemistry Baylor UniversityP.O.Box 97348WacoTX 76798USA. U.S.Environmental Protection Agency National Exposure Research LaboratoryEnvironmental Sciences Division944 East Harmon AveLas VegasNV 89119USA

Low levels (ng/g) of musk ketone (MK),used as a fragrance additive in the formulation of personal care products,are frequently detected in the water and other ***,aquatic organisms can be continuously exposed to *** this study,kinetics and dose-response assessments of 2-amino-MK (AMK) metabolite,bound to cysteine-hemoglobin (Hb) in rainbow trout,formed by enzymatic nitro-reduction of MK have been *** were exposed to a single exposure of 0.010,0.030,0.10,and 0.30 mg MK/g ***...

关键词： biotransformation kinetics hemoglobin adducts dose-response nitro musks biomarker fish

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Pancreatic cancer survival trends in the US from 2001 to 2014:a CONCORD-3 study

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Cancer Communications 2023年第1期43卷 87-99页

作者： Maja Nikšić Pamela Minicozzi Hannah K Weir Heather zimmerman Maria J Schymura Judith R Rees Michel P Coleman Claudia Allemani 无 Cancer Survival Group Department of Non-Communicable Disease EpidemiologyLondon School of Hygiene&Tropical MedicineKeppel StreetLondon WC1E 7HTUK Centre for Health Services Studies University of KentCanterbury CT27NFUK Division of Cancer Prevention and Control Centers for Disease Control and PreventionAtlantaGA 30333USA Montana Central Tumor Registry Chronic Disease Prevention and Health Promotion BureauPO Box 2029511400 BroadwayHelenaMT 59620-2951USA Bureau of Cancer Epidemiology New York State Cancer RegistryNew York State Department of Health150 BroadwayAlbanyNY 12204-2719USA New Hampshire State Cancer Registry Norris Cotton Cancer Centerand Department of EpidemiologyGeisel School of MedicineDartmouth CollegeDartmouth-Hitchcock Medical CenterOne Medical Center DriveLebanonNH 03756USA Cancer Division University College London Hospitals NHS Foundation Trust250 Euston RoadLondon NW12PGUK US CONCORDWorking Group

Background:Survival from pancreatic cancer is low *** the US,the 5-year relative survival has been slightly higher for women,whites and younger patients than for their counterparts,and differences in age and stage at diagnosis[Corrections added Nov 16,2022,after first online publication:a new affiliation is added to Maja Nikšić]may contribute to this *** aimed to examine trends in survival by race,stage,age and sex for adults(15-99 years)diagnosed with pancreatic cancer in the ***:This population-based study included 399,427 adults registered with pancreatic cancer in 41 US state cancer registries during 2001-2014,with followup to December 31,*** estimated age-specific and age-standardized net survival at 1 and 5 ***:Overall,12.3%of patients were blacks,and 84.2%were *** 9.5%of patients were diagnosed with localized disease,but 50.5%were diagnosed at an advanced stage;slightly more among blacks,mainly among *** substantial changes were seen over time(2001-2003,2004-2008,2009-2014).In general,1-year net survival was higher in whites than in blacks(26.1%vs.22.1%during 2001-2003,35.1%vs.31.4%during 2009-2014).This difference was particularly evident among patients with localized disease(49.6%in whites vs.44.6%in blacks during 2001-2003,60.1%vs.55.3%during 2009-2014).The survival gap between blacks and whites with localized disease was persistent at 5 years after diagnosis,and it widened over time(from 24.0%vs.21.3%during 2001-2003 to 39.7%vs.31.0%during 2009-2014).The survival gap was wider among men than among ***:Gaps in 1-and 5-year survival between blacks and whites were persistent throughout 2001-2014,especially for patients diagnosed with a localized tumor,for which surgery is currently the only treatment modality with the potential for cure.

关键词： pancreatic cancer race/ethnicity stage net survival population-based cancer registries

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医务人员呼吸防护用品适合性检验和密合性检查有效性的系统综述

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International Journal of Nursing Sciences 2023年第4期10卷 568-578页

作者： Charlotte Goko Elizabeth Forster Matthew Mason Peta-Anne zimmerman School of Nursing&Midwifery Griffith UniversityAustralia Menzies Health Institute Queensland Griffith UniversityAustralia Collaborative for the Advancement of Infection Prevention and Control Australia University of the Sunshine Coast QueenslandAustralia Infection Control Department Gold Coast Hospital and Health ServicesAustralia

目的呼吸防护在医疗卫生工作中至关重要,应使用适当的颗粒过滤呼吸器和等效的呼吸防护用品,以确保良好的佩戴气密性,最大限度地降低医务人员的空气传播感染风险。该文旨在对呼吸防护用品适合性检验和密合性检查有效性研究进行综述和分... 详细信息

目的呼吸防护在医疗卫生工作中至关重要,应使用适当的颗粒过滤呼吸器和等效的呼吸防护用品,以确保良好的佩戴气密性,最大限度地降低医务人员的空气传播感染风险。该文旨在对呼吸防护用品适合性检验和密合性检查有效性研究进行综述和分析。方法系统检索了2003年1月至2022年4月发表的文献,检索范围包括CINAHL、Cochrane图书馆、EMBASE、PubMed、Ovid数据库Medline子库和灰色文献。研究方案已在PROSPERO注册(CRD42020213968)。结果共检索出561篇文献,25篇被纳入该综述,包括22项量性研究和3篇指南文献。在评估呼吸防护用品的有效性方面,适合性检验是更有效且被广泛采用的可靠方法,但呼吸防护程序应该同时包括适合性检验和密合性检查,以最大限度地提高呼吸防护用品的有效性。新型冠状病毒疫情凸显了医务人员相关知识的缺乏,相关教育培训可有效提高呼吸防护用品使用的有效性。结论为确保医务工作者的安全,适合性测试和密合性检查均应采用。建议由专业人员实施全面的呼吸防护项目,包括教育培训、适合性测试和密合性检查,还需要探索适用于实际使用环境的适合性检验方法。

关键词：适合性检验密合性检查医护人员呼吸防护用品个人防护装备佩戴气密性检查

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Planetary defense mission concepts for disrupting/pulverizing hazardous asteroids with short warning time

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Astrodynamics 2017年第1期1卷 3-21页

作者： Bong Wie Ben zimmerman Joshua Lyzhoft George Vardaxis Department of Aerospace Engineering Iowa State UniversityAmesIowa 50011USA

This paper presents an overview of space mission concepts for disrupting or pulverizing hazardous asteroids, especially with warning time shorter than approximately 10 years. An innovative mission concept, referred to as a nuclear hypervelocity asteroid intercept vehicle (HAIV) system, employs both a kinetic-energy impactor and nuclear explosive devices. A new mission concept of exploiting a multiple kinetic-energy impactor vehicle (MKIV) system that doesn’t employ nuclear explosives is proposed in this paper, especially for asteroids smaller than approximately 150 m in diameter. The multiple shock wave interaction effect on disrupting or pulverizing a small asteroid is discussed using hydrodynamic simulation results. A multi-target terminal guidance problem and a planetary defense mission design employing a heavy-lift launch vehicle are also brie y discussed in support of the new non-nuclear MKIV mission concept. The nuclear HAIV and non-nuclear MKIV systems complement to each other to effectively mitigate the various asteroid impact threats with short warning time.

关键词： planetary defense kinetic-energy impactor(KEI) asteroid disruption terminal intercept guidance heavy-lift launch vehicles(HLLV)

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More than Target 6.3： A Systems Approach to Rethinking Sustainable Development Goals in a Resource-Scarce World

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Engineering 2016年第4期2卷 481-489页

作者： Qiong Zhang Christine Prouty Julie B. zimmerman James R. Mihelcic University of South Florida Tampa EL 33620 USA Yale University New Haven CT06520 USA

《2030年可持续发展议程》概述了17个独立的可持续发展目标(SDGs),用于指导世界范围内包括工程、科研、政策和发展在内的大量专业学科的实践。SDGs致力于减少贫困、饥饿和疾病,同时致力于改善性别歧视、环境恶化以及水和卫生设施匮乏的... 详细信息

《2030年可持续发展议程》概述了17个独立的可持续发展目标(SDGs),用于指导世界范围内包括工程、科研、政策和发展在内的大量专业学科的实践。SDGs致力于减少贫困、饥饿和疾病,同时致力于改善性别歧视、环境恶化以及水和卫生设施匮乏的现状。但是,如果我们采取传统的简化方法研究和优化其中的单一目标,很可能由于在实现其他目标时带来的意外后果,而导致在技术、政策或管理层面的失败。本研究采用系统分析方法研究SDGs之间的动态机理,识别个体目标之间的协同或拮抗作用,构建了一个概念系统模型来说明SDGs之间的因果联系,利用了通用系统基模来检验系统结构,确定了杠杆节点来有效控制系统中的预期变化并最小化非预期变化。SDGs之间相互作用的结构反映了系统行为的三种基模:强化成长、成长上限和成长与投资不足。由概念模型确定的杠杆节点包括:性别平等、水和卫生设施的可持续管理、可替代资源、可持续生活标准和全球伙伴关系。这种对SDGs的概念系统分析能够加深发展社区对资源管理、环境可持续发展和气候变化相关项目带来的潜在协同效应的理解。通过把项目间的影响和反馈与经济收益、妇女平权和教育平等联系起来,利益相关者可以意识到可从整体上改善全球众多贫困群体的生活质量。

关键词：可持续发展目标原型系统世界资源稀缺有效相互作用环境可持续性卫生设施协同效应

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富铁橄榄石的高温变形实验研究

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岩石学报 2005年第3期21卷 999-1004页

作者：赵永红 zimmerman M Kohlstedt D L 北京大学地球物理学系北京100871 明尼苏达大学地质与地球物理系

利用高精度Paterson气体介质变形装置对(Mg0.5,Fe0.5)2SiO4和(Mg0.7,Fe0.3)2SiO4橄榄石集合体进行了高温三轴压缩变形试验。首先用人工合成了纯铁橄榄石Fe2SiO4,然后用合成的纯铁橄榄石与天然圣卡罗橄榄石按一定比例混合烧结合成了含铁... 详细信息

利用高精度Paterson气体介质变形装置对(Mg0.5,Fe0.5)2SiO4和(Mg0.7,Fe0.3)2SiO4橄榄石集合体进行了高温三轴压缩变形试验。首先用人工合成了纯铁橄榄石Fe2SiO4,然后用合成的纯铁橄榄石与天然圣卡罗橄榄石按一定比例混合烧结合成了含铁量分别为50％和30％的富铁橄榄石集合体Fo50和Fo70。三轴压缩蠕变变形试验在温度1223-1473 K和围压 300 MPa的条件下进行,差应力为10-300 MPa,应变率为10-7-10-4s-1,每个试件的最大变形量为20％．利用三维非线性方法对蠕变数据进行拟合,得出的流动律中,Fo50应力指数为4．1,活化能为499kJ／mol;Fo70应力指数为4．3,活化能为510kJ／ mol。将实验结果与Fo90圣卡罗橄榄石集合体的强度进行对比,发现含铁量的增加使橄榄石的强度明显下降,Fo50橄榄石集合体比Fo70的粘性低一个量级,Fo70比Fo90的粘性低一个量级。从而得到了含铁量对橄榄石的粘性(强度)影响的初步试验结果。

关键词：富铁橄榄石高温蠕变三轴压缩实验研究

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日本夏日祭终于回归了

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商业周刊（中文版） 2023年第11期 46-48页

作者： Max zimmerman 孟洁冰(译) 不详

●在日本正式取消最后的新冠防疫限制措施几个月后,人们恢复正常生活最重要的标志也许就是夏日祭的回归6月,从当地社区的小规模集会到持续数周的全市巡游,祭典活动在日本各地拉开了惟幕,恢复了日本城市肌理的重要组成部分。有些祭典是... 详细信息

●在日本正式取消最后的新冠防疫限制措施几个月后,人们恢复正常生活最重要的标志也许就是夏日祭的回归6月,从当地社区的小规模集会到持续数周的全市巡游,祭典活动在日本各地拉开了惟幕,恢复了日本城市肌理的重要组成部分。有些祭典是疫情发生以来首次回归,而另一些祭典在缩小规模后再次以盛大的活动亮相。

关键词：城市肌理限制措施当地社区祭典回归日本

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Twenty-first century climate change and submerged aquatic vegetation in a temperate estuary:the case of Chesapeake Bay

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Ecosystem Health and Sustainability 2017年第7期3卷 14-34页

作者： Thomas M.Arnold Richard C.zimmerman Katharina A.M.Engelhardt J.Court Stevenson Departments of Biology and Environmental Studies Dickinson CollegeCarlislePAUSA Department of Ocean Earth and Atmospheric SciencesOld Dominion UniversityNorfolkVAUSA Appalachian Laboratory University of Maryland Center for Environmental ScienceFrostburgMDUSA Horn Point Laboratory University of Maryland Center for Environmental ScienceCambridgeMDUSA

Introduction:The Chesapeake Bay was once renowned for expansive meadows of submerged aquatic vegetation(SAV).However,only 10%of the original meadows *** restoration effortswill be complicated by accelerating climate change,including physiological stressors such as a predicted mean temperature increase of 2-6℃and a 50-160%increase in CO_(2)***:As the Chesapeake Bay begins to exhibit characteristics of a subtropical estuary,summer heat waves will become more frequent and *** alone would eventually eliminate eelgrass(Zostera marina)from the *** will favor native heat-tolerant species such as widgeon grass(Ruppia maritima)while facilitating colonization by non-native seagrasses(e.g.,Halodule spp.).Intensifying human activity will also fuel coastal zone acidification and the resulting high CO_(2)/low pH conditions may benefit SAV via a“CO_(2)fertilization effect.”Discussion:Acidification is known to offset the effects of thermal stress and may have similar effects in estuaries,assuming water clarity is sufficient to support CO_(2)-stimulated photosynthesis and plants are not overgrown by ***,coastal zone acidification is variable,driven mostly by local biological processes that may or may not always counterbalance the effects of regional *** precarious equipoise between two forces-thermal stress and acidification-will be critically important because it may ultimately determine the fate of cool-water plants such as Zostera marina in the Chesapeake ***:The combined impacts of warming,coastal zone acidification,water clarity,and overgrowth of competing algae will determine the fate of SAV communities in rapidly changing temperate estuaries.

关键词： Submerged aquatic vegetation climate temperature coastal acidification Chesapeake Bay

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