检索结果-南通市图书馆

Update on obesity surgery

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2006年第20期12卷 3196-3203页

作者： Dan Eisenberg Andrew J duffy Robert l Bell Department of Surgery Yale University School of Medicine 40 Temple St. Suite 3A New HavenCT 06510United States

The prevalence of obesity in the United States has reached epidemic proportions. With more than 30 million Americans clinically obese, the younger population has also been affected. Surgical therapy should be offered to the severely obese patient who is refractory to nonsurgical therapy, as established by the 1991 NIH Consensus Conference on Gastrointestinal Surgery for Severe Obesity. Surgery is currently the most effective therapy for weight loss. It is far more effective than any other treatment modality, both in terms of the amount of weight loss and in terms of durability in maintaining weight loss.

关键词： Obesity Gastrointestinal surgery Roux-Y gastric bypass

Controversies in the treatment of gastroesophageal reflux and achalasia

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2006年第20期12卷 3155-3161页

作者： k.rt E Roberts Andrew J duffy Robert l Bell Department of Surgery Yale University School of Medicine 40 Temple St. Suite 3 ANew HavenCT 06510United States

The immense success of laparoscopic surgery as an effective treatment of gastroesophageal reflux disease （GERD） and achalasia has established minimal invasive surgery as the gold standard for these two conditions with lower morbidity and mortality, shorter hospital stay, faster convalescence, and less postoperative pain. One controversy in the treatment of GERD evolves around laparoscopic antireflux surgery （lAP, S） as the preferred treatmerit for Barrett＇s esophagus and the procedure＇s potential to reduce the risk.of adenocarcinoma of the esophagus. GERD has also been associated with respiratory symptoms, asthma and laryngeal injury, and a second controversy prompts discussions about whether total or partial fundoplication is the more appropriate treatment for GERD. A new and promising alternative in the treatment of GERD is endoluminal therapy. Three types of this new treatment option will be discussed： radiofrequency energy delivered to the lower esophageal sphincter, the creation of a mechanical barrier at the gastroesophageal junction, and the direct endoscopic tightening of the lower esophageal sphincter. laparoscopic surgery is discussed not only as a very effective treatment for GERD but also as permanent cure for achalasia. This review analyzes the three most important treatment options for achalasia： medications, pneumatic dilatation, and surgical therapy. Medications as the only true non-invasive option in the treatment of achalasia are not as effective as lAPS because of their short half-life and variable absorption due to the poor esophageal emptying. The second treatment option, pneumatic dilatation, involves the stretching of the lower esophagus and is still considered the most effective nonsurgical treatment for achalasia. Finally, surgical therapy for achalasia and the two major controversies concerning this laparoscopic treatment are discussed. The first involves the extent to which the myotomy is extended onto the stomach, and the second concer

关键词： Gastroesophageal reflux disease Nissen Toupet Fundoplication Achalasia Heller myotomy

Evolution of surgical sk.lls training

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2006年第20期12卷 3219-3224页

作者： k.rt E Roberts Robert l Bell Andrew J duffy Department of Surgery Yale University School of Medicine 40 Temple StreetSuite 3ANew HavenCT 06510United Staets

Surgical training is changing： one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work.hours restrictions, the cost of operating room time, and complications. Surgical simulation and sk.lls training offers an opportunity to teach and practice advanced sk.lls outside of the operating room environment before attempting them on living patients. Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated ＂tissue＂ in a box trainer. More advanced, virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. The Accreditation Council of Graduate Medical Education＇s （ACGME） has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of sk.lls, advance surgical training, and to credential surgeons as technically competent. Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery. An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training, ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients.

关键词： Surgery Training Certification Sk.lls Simulation Curriculum

Stable isotope evidence for trophic niche partitioning in a South African savanna rodent community

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Current Zoology 2015年第3期61卷 397-411页

作者： Jacqueline CODRON k.vin J duffy Nico l AVENANT Matt SPONHEIMER Jennifer lEICHlITER Oliver PAINE Paul SANDBERG Daryl CODRON Institute of Systems Science Durban University of Technology Durban South Africa k.roo Palaeontology Deparlnaent National Museum PO Box 266 Bloemfontein 9301 RSA School of Mathematics Statistics and Computer Science University of KwaZulu-Natal Private Bag X01 Scottsville 3209 RSA Denartment of Mammalogv. National Museum. PO Box 266. Bloemfontein 9301. RSA Department of Anthropology University of Colorado at Boulder Boulder CO80309 USA Florisbad Quaternary Research Department National Museum PO Box 266 Bloemfontein 9301 RSA

Species＇ partitioning of resources remains one of the most integral components for understanding community assem- bly. Analysis of stable carbon and nitrogen isotopes in animal tissues has the potential to help resolve patterns of partitioning be- cause these proxies represent the individual＇s diet and trophic niche, respectively. Using free-ranging rodents in a southern Afri- can savanna as a model community, we find that syntopic species within habitats occupy distinct isotope niches. Moreover, spe- cies with strongly overlapping isotope niches did not overlap in their spatial distribution patterns, suggesting an underlying effect of competitive exclusion. Niche conservatism appears to characterize the behaviour of most species in our sample - with little or no observed changes across habitats - with the exception of one species, Mastomys coucha. This species displayed a generalist distribution, being found in similar abundances across a variety of habitats. This spatial pattern was coupled with a generalist isotope niche that shifted across habitats, lik.ly in response to changes in species composition over the same spatial gradient. The case for M. coucha supports contentions that past competition effects played a significant evolutionary role in shaping community structures of today, including the absence of strong interspecific niche overlaps within particular habitats. Our study highlights the value of stable isotope approaches to help resolve k.y questions in community ecology, and moreover introduces novel ana- lytical approaches to quantifying isotope niche breadths and niche overlaps that are easily comparable with traditional metrices

关键词： Competition Diet Niche breadth Niche overlap Sterk.ontein Valley

A hierarchical indexing strategy for optimizing Apache Spark.with HDFS to efficiently query big geospatial raster data

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

International Journal of Digital Earth 2020年第3期13卷 410-428页

作者： Fei Hu Chaowei Yang Yongyao Jiang Yun li Weiwei Song Daniel Q.duffy John l.Schnase Tsengdar lee NSF Spatiotemporal Innovation Center and Dept.of Geography and GeoInformation Sciences George Mason UniversityFairfaxVAUSA Center for Open-Source Data and AI Technologies IBMSan FranciscoCAUSA Office of Computational and Information Sciences and Technology NASA Goddard Space Flight CenterGreenbeltMDUSA NASA Center for Climate Simulation Goddard Space Flight CenterGreenbeltMDUSA Earth Science Division NASA HeadquartersWashingtonDCUSA

Earth observations and model simulations are generating big multidimensional array-based raster ***,it is difficult to efficiently query these big raster data due to the inconsistency among the geospatial raster data model,distributed physical data storage model,and the data pipeline in distributed computing *** efficiently process big geospatial data,this paper proposes a three-layer hierarchical indexing strategy to optimize Apache Spark.with Hadoop Distributed File System(HDFS)from the following aspects:(1)improve I/O efficiency by adopting the chunk.ng data structure;(2)k.ep the work.oad balance and high data locality by building the global index(k.d tree);(3)enable Spark.and HDFS to natively support geospatial raster data formats(e.g.,HDF4,NetCDF4,GeoTiff)by building the local index(hash table);(4)index the in-memory data to further improve geospatial data queries;(5)develop a data repartition strategy to tune the query parallelism while k.eping high data *** above strategies are implemented by developing the customized RDDs,and evaluated by comparing the performance with that of Spark.SQl and *** proposed indexing strategy can be applied to other distributed framework. or cloud-based computing systems to natively support big geospatial data query with high efficiency.

关键词： Big data hierarchical indexing multi-dimensional Apache Spark HDFS distributed computing GIS

Implementation and evaluation of Exercise is Medicine in primary care clinics within a large academic health system

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Family Medicine and Community Health 2024年第1期12卷 16-27页

作者： John k.vin Ong Dayao Caroline E l duffy Amalia M Cristiano Gene'Rusty'k.llenberg Sarah E link. University of California San Diego School of Medicine La JollaCaliforniaUSA Milk.n Institute of Public Health The George Washington UniversityWashingtonDistrict of ColumbiaUSA The University of Texas Medical Branch at Galveston School of Medicine GalvestonTexasUSA Scripps Family Medicine Residency Scripps Mercy Hospital Chula VistaChula VistaCaliforniaUSA Herbert Wertheim School of Public Health&Human longevity Science University of California San DiegoLa JollaCaliforniaUSA Department of Family Medicine University of California San DiegoLa JollaCaliforniaUSA Omada Health San FranciscoCaliforniaUSA

Objective Exercise is Medicine(EIM)is a global initiative encouraging healthcare providers to routinely assess and promote physical activity(PA)among *** objective of this study was to evaluate the feasibility,adoption,implementation and effectiveness of EIM from patient,clinician and healthcare staff perspectives using a combination of electronic health record(EHR),survey and interview *** This study used a combination of the Practical Robust Implementation and Sustainability Model(PRISM)and the learning Evaluation model to implement *** captured from the EHR,including Physical Activity Vital Sign(PAVS)scores,and data collected from qualitative surveys and interviews were used to evaluate the programme’s Reach,Effectiveness,Adoption,Implementation,Maintenance(RE-AIM,which is embedded within PRISM)from provider,staff and patient *** Five primary care clinics within a large academic health *** A total of 24443 patients from all participating clinics had at least one PAVS score during the study period.A total of 17 clinicians completed surveys,and 4 clinicians,8 medical assistants and 9 patients completed *** Implementation fidelity metrics varied widely between components and across clinics but were generally consistent over time,indicating a high degree of programme *** was highest during the first 6 months of the COVID-19 pandemic when most visits were *** PAVS scores increased from 57.7(95%CI:56 to 59.4)to 95.2(95%CI:91.6 to 98.8)min per week.at 6 months for patients not meeting PA guidelines at baseline and decreased from 253.84(95%CI:252 to 255.7)to 208.3(95%CI:204.2 to 212.4)min per week.at 6 months for patients meeting PA guidelines at *** EIM implementation,clinician-estimated time spent discussing PA with patients increased for 35%of providers and stayed the same for 53%.Conclusion Overall,this study established EIM’s feasibility,adoption,implementation

关键词： routine qualitative completed

Oxidative Stress in Collegiate Cross Country Sk.ers in Mid- and Post-Seasons

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Biosciences and Medicines 2024年第5期12卷 99-110页

作者： Scott P. Jerome k.iya l. Dunlap Ava M. Parrish Matthew l. lowman Emily M. Shipman l.wrence k. duffy Arleigh J. Reynolds Department of Chemistry & Biochemistry University of Alaska Fairbanks Fairbanks AK USA Institute of Arctic Biology University of Alaska Fairbanks Fairbanks AK USA Department of Biology & Wildlife University of Alaska Fairbanks Fairbanks AK USA Department of Veterinary Medicine University of Alaska Fairbanks Fairbanks AK USA

Purpose: The oxidative stress (OS) hypothesis of overtraining syndrome argues that increased production of free radicals through exercise cause muscle fatigue and damage resulting in lower athletic performance. Several studies have investigated OS immediately before and after exercise bouts in a training macrocycle. Our study aimed to compare OS of endurance athletes between a competition macrocycle and the immediate post-season recovery macrocycle. In addition, we aimed to identify athletes who experienced an unexplainable drop in athletic performance during the competition season in order to compare their OS to those who experienced no drop in performance. Methods: Fifteen members of the University of Alask. Fairbank. cross country sk. team volunteered for this study. Blood samples were tak.n in early February (“mid-season”) and late April (“post-season”). Participants completed questionnaires regarding physical activity and athletic performance at the time of the blood draws. Plasma was analyzed for 4-hydroxynonenal (HNE), nitrotyrosine, nitric oxide (NOX), and superoxide dismutase (SOD). Significance was determined by Wilcoxon and Mann-Whitney tests. Results: Participants displayed significantly higher (p Conclusion: Signs of oxidative stress and mitigation during the post-season recovery macrocycle were higher in athletes who reported experiencing a drop in athletic performance during the competition season macrocycle.

关键词： Oxidative Stress 4-Hydroxynonenal Superoxide Dismutase Athletic Performance Training Macrocycle

From biomimicry to bioelectronics:Smart materials for cardiac tissue engineering

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Nano Research 2020年第5期13卷 1253-1267页

作者： Olurotimi A.Bolonduro Breanna M.duffy Ak.hita A.Rao lauren D.Black.Brian P.Timk. Department of Biomedical Engineering Tufts UniversityMedfordMassachusetts 02155USA Department of Cell Molecular&Developmental BiologySchool of Graduate Biomedical SciencesTufts UniversityMassachusetts 02111USA

Effective strategies in cardiac tissue engineering require matrices that recapitulate the mechanical,topographic and electrical cues present in the native extracellular *** this review,we discuss recent efforts in materials science and nanotechnology to achieve functional three-dimensional(3D)scaffolds that modulate and monitor cardiac tissue *** consider k.y design considerations,including choice of biopolymer matrix,cell sources,and delivery methods for eventual *** then discuss how solid-state nanomaterials may be integrated within these systems to provide unique electrical and nanotopographic cues that improve electromechanical *** describe how these approaches may be extended to complex,spatially heterogeneous constructs using 3D bioprinting ***,we describe how scaffold materials may be augmented with bioelectronic components to achieve hybrid myocardium that monitors or controls electrophysiological ***,these approaches provide a framework.for achieving cardiac tissues with tunable,rationally-designed *** discuss future prospects and remaining challenges for clinical translation.

关键词： cardiac tissue engineering extracellular matrix nanomaterial bioelectronics cyborg

Quantifying Hydrologic and Water Quality Responses to Bioenergy Crops in Town Creek.Watershed in Mississippi

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Sustainable Bioenergy Systems 2013年第3期3卷 202-208页

作者： Prem B. Parajuli Sarah E. duffy Department of Agricultural and Biological Engineering Mississippi State University Starkville USA

Bioenergy crops are considered as a feedstock.source, which can be grown in marginal soils. However, these crops may have different levels of crop yield potential and environmental benefits. The objectives of this study were to model and compare the effects of four bioenergy crops (corn—Zea mays, soybean—Glycine max (l.) Merr., miscanthus—Miscanthus-giganteus, and switchgrass—Panicum virgatum) in the Town Creek.watershed (TCW) in northeast Mississippi using the Soil and Water Assessment Tool (SWAT) model. The calibrated SWAT model for TCW was used to quantify impacts to streamflow, crop yield, and sediment yield. The SWAT model reasonably (long-term (January, 1990 to September, 2009) monthly streamflow (25.88 m3·s-1) from the TCW when compared with the USGS observed stream flow (29.34 m3·s-1. In addition, model reasonably predicted (±6%) average annual corn yield (4.66 Mg·ha-1) and soybean yield (1.42 Mg·ha-1) as compared to National Agricultural Statistics Service (NASS) reported average annual corn (4.96 Mg·ha-1) and soybean yield (1.34 Mg·ha-1) from the watershed. Further, the model simulated results from this study determined that long-term average annual feedstock.yield from TCW is the greatest when growing miscanthus grass (817,732 Mg) followed by switchgrass (477,317 Mg), corn (236,132 Mg), and soybeans (65,235 Mg). The SWAT model predicted the greatest annual average sediment yield (6.62 Mg·ha-1) from continuous corn crop scenario while the perennial grasses (switchgrass and miscanthus) had the lowest sediment yield (2.91 Mg·ha-1 and 3.20 Mg·ha-1 respectively). Overall, producing a perennial grass in the TCW would provide the largest biomass feedstock.source with the least environmental impact. The results of this study will help to lang="EN-US" style="

关键词： Perennial Grass Water Quality Watershed SWAT