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Incident frailty and cognitive impairment by heart failure status in older patients with atrial fibrillation: the SAGE-AF study

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Journal of Geriatric Cardiology 2020年第11期17卷 653-658页

作者： Wei-Jia WANG Darleen Lessard Jane Saczynski robert J goldberg alan S.Go Tenes Paul Ely Gracia David D McManus Department of Medicine University of Massachusetts Medical SchoolWorcesterMAUSA Department of Population and Quantitative Health Sciences University of Massachusetts Medical SchoolWorcesterMAUSA Department of Pharmacy and Health System Sciences Northeastern UniversityBostonMAUSA Division of Research Kaiser Permanente Northern CaliforniaOaklandCAUSA

Background Atrial fibrillation(AF) and heart failure(HF) frequently co-occur in older individuals. Among patients with AF, HF increases risks for stroke and death, but the associations between HF and incident cognition and physical impairment remain unknown. We aimed to examine the cross-sectional and prospective associations between HF, cognition, and frailty among older patients with AF. Methods The SAGE-AF(Systematic Assessment of Geriatric Elements in AF) study enrolled 1244 patients with AF(mean age 76 years, 48% women) from five practices in Massachusetts and Georgia. HF at baseline was identified from electronic health records using ICD-9/10 codes. At baseline and 1-year, frailty was assessed by Cardiovascular Health Survey score and cognition was assessed by the Montreal Cognitive Assessment. Results Patients with prevalent HF(n = 463, 37.2%) were older, less likely to be non-Hispanic white, had less education, and had greater cardiovascular comorbidity burden and higher CHA2 DS2 VASC and HAS-BLED scores than patients without HF(all P's < 0.01). In multivariable adjusted regression models, HF(present vs. absent) was associated with both prevalent frailty(adjusted odds ratio [a OR]: 2.38, 95% confidence interval [CI]: 1.64-3.46) and incident frailty at 1 year(a OR: 2.48, 95% CI: 1.37-4.51). HF was also independently associated with baseline cognitive impairment(a OR: 1.60, 95% CI: 1.22-2.11), but not with developing cognitive impairment at 1 year(a OR 1.04, 95%CI: 0.64-1.70). Conclusions Among ambulatory older patients with AF, the co-existence of HF identifies individuals with physical and cognitive impairments who are at higher short-term risk for becoming frail. Preventive strategies to this vulnerable subgroup merit consideration.

关键词： Atrial fibrillation Cognitive impairment Heart failure Frailty

Excess dietary Lys reduces feed intake, stimulates jejunal CCK secretion and alters essential and non‑essential blood AA profile in pigs

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Journal of Animal Science and Biotechnology 2024年第3期15卷 1336-1346页

作者： Maximiliano Muller Elout Van Liefferinge alan Tilbrook robert van Barneveld Eugeni Roura Centre for Nutrition and Food Sciences Queensland Alliance for Agriculture and Food InnovationThe University of QueenslandBrisbaneQueensland 4072Australia Laboratory of Animal Nutrition and Animal Product Quality(LANUPRO) Department of Animal Sciences and Aquatic EcologyGhent University339000 GhentFlandersBelgium Centre for Animal Science Queensland Alliance for Agriculture and Food Innovation and the School of Veterinary ScienceThe University of QueenslandBrisbaneQueensland 4072Australia SunPork Group BrisbaneQueensland 4009Australia

Background Commercial diets are frequently formulated to meet or exceed nutrient levels including those of lim-iting essential amino acids(AA)covering potential individual variations within the ***,the provision of dietary excess of AA,such as Lys,may lead to reduced appetite and growth in *** mechanisms modulat-ing these responses have not been extensively *** study evaluated the effect of Lys dietary excesses on performance and satiety biomarkers in post weaning *** Twenty-four pigs aged 21 d and weighing 6.81±0.12kg(mean±SEM)were individually housed and offered 1 of 4 dietary treatments for 3weeks:a diet containing a standardized ileal digestible Lys reaching 100%(T0),120%(T1),150%(T2)or 200%(T3)of the NRC(2012)*** the end of the experiment,blood samples from the cephalic vein of the T0 and T3 groups were obtained for AA *** addition,primary intestinal cultures from T0 pigs were used,following their humane killing,to evaluate the effect of Lys on gut hormone secretion and AA sensors gene expression under ex vivo *** Feed intake was linearly reduced(P<0.001)and the weight gain to feed ratio reduced(P<0.10)with increased dietary levels of Lys during the third-and first-week post weaning,*** con-centration(P<0.05)and the metabotropic glutamate receptor 1 and the solute carrier family 7 member 2(P<0.10)gene expression was enhanced in proximal jejunum tissues incubated with Lys at 20mmol/L when compared to the control(Lys 0mmol/L).Plasma Lys and Glu(P<0.05)concentration increased in the T3 compared to T0 *** contrast,plasma levels of His,Val,Thr,Leu(P<0.05)and Gln(P<0.10)were lower in T3 than T0 *** The present results confirm that excess dietary Lys inhibits hunger in ***,the results provide evidence of pre-and post-absorptive mechanisms modulating these *** dietary excesses should be nar-rowed,when possible,to avoid negative effects of

关键词： Amino acid Blood Cholecystokinin Feed intake Lysine Pig Satiety

Conservation of natural enemy fauna in citrus canopies by horticultural mineral oil： Comparison with effects of carbaryl and methidathion treatments for control of armored scales

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Insect Science 2010年第5期17卷 414-426页

作者： Weiguang Liang alan Meats G. Andrew C. Beattie robert Spooner-Hartt Laura Jiang Centre for Plant and Food Sciences University of Western Sydney School of Biological Sciences University of Sydney Sydney New South Wales Austrafia

The disruptive effects of an nC24 horticultural mineral oil （HMO） and two other insecticides （carbaryl and methidathion） on two armored scale insects and natural enemy fauna were evaluated in two citrus orchards. In the first orchard, all three spray treatments and non-sprayed controls were distributed separately among individual trees in one block, whereas in the second orchard the control, HMO and methidathion treatments were applied at the level of whole blocks. The results in both orchards were similar. All three of the spray treatments had a lethal effect on the red scale insects and the effects of HMO and methidathion tested at the second site lasted for at least 19 weeks and for purple scale, at least 50 weeks. HMO did not have a significant effect on the abundance and species diversity of parasitoids and （for the most part） did not affect coccinellids and predatory mites. Both carbaryl and methidathion caused significant ongoing disruption to the above groups. No treatment resulted in the resurgence of the scale insects or the outbreak ofphytophagous mites, even where whole blocks were sprayed.

关键词： conservation HMO replacement resurgence water saving

Appraisal of the current guidelines for management of cholangiocarcinoma-using the Appraisal of Guidelines Research and Evaluation Ⅱ (AGREE Ⅱ) Instrument

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Hepatobiliary Surgery and Nutrition 2020年第2期9卷 126-135,中插1页

作者： Paschalis Gavriilidis alan Askari Keith J.roberts robert P.Sutcliffe Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery Queen Elizabeth University Hospitals Birmingham NHS Foundation TrustBirminghamUK Department of Upper Gastro-Intestinal Surgery West Hertfordshire Hospitals NHS TrustWatfordUK

Cholangiocarcinoma(CC)is the second most common primary liver ***-quality guidelines are essential for effective patient stratification and individualised *** study aimed to appraise the methodological quality of existing guidelines for the resection of CC using the Appraisal of Guidelines for Research&Evaluation(AGREE II)instrument.A systematic search of the literature in Cochrane,PubMed,Google Scholar,and Embase was *** of the clinical practice guidelines(CPGs)and consensuses was performed using the AGREE II instrument by four clinicians experienced in surgical practice and the AGREE II appraisal *** searches identified 13 guidelines of highly variable quality according to the AGREE II *** guidelines scored well in certain domains such as scope&purpose(median score across all guidelines;65%),clarity of presentation(76%),and editorial independence(56%).However,they scored poorly for applicability(13%),rigour of development(30%),and stakeholder involvement(39%).None of the 13 guidelines was recommended universally for use without ***,the methodological quality of guidelines on the surgical management of CC is *** updates should address and modify shortcomings detected by the AGREE II instrument,thereby facilitating better patient stratification and individualised treatment strategies.

关键词： Cholangiocarcinoma(CC) clinical practice guidelines(CPGs) Appraisal of Guidelines for Research and Evaluation instrument(AGREE II instrument)

Hearing loss and cognitive decline among older adults with atrial fibrillation:the SAGE-AF study

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Journal of Geriatric Cardiology 2020年第4期17卷 177-183页

作者： Wei-Jia WANG Darleen Lessard Hawa Abu David D.McManus Tanya Mailhot Jerry H.Gurwitz robert J.goldberg Jane Saczynski Division of Cardiovascular Medicine Department of MedicineUniversity of Massachusetts Medical SchoolWorcesterMAUSA Department of Population and Quantitative Health Sciences University of Massachusetts Medical SchoolWorcesterMAUSA Department of Pharmacy and Health System Sciences Northeastern UniversityBostonMAUSA Meyers Primary Care Institute University of Massachusetts Medical SchoolWorcesterMAUSA

Objective To examine the association between hearing loss and cognitive function cross-sectionally and prospectively among older adults with atrial fibrillation(AF).Methods Patients with AF≥65-year-old(n=1244)in the SAGE(Systematic Assessment of Geriatric Elements)-AF study were recruited from five internal medicine or cardiology clinics in Massachusetts and *** was assessed by a structured questionnaire at *** function was assessed by Montreal Cognitive Assessment(MoCA)at baseline and one *** impairment was defined as score≤23 on the *** associations between hearing loss and cognitive function were examined by multivariable adjusted logistic *** Participants with hearing loss(n=451,36%)were older,more likely to be male,and have depressive symptoms than patients without hearing *** baseline,528(42%)participants were cognitively *** with hearing loss were significantly more likely to have cognitive impairment at baseline[adjusted odds ratio(OR)=1.37,95%confidence interval(CI):1.05–1.81].Among the 662 participants who did not have cognitive impairment at baseline and attended the one-year follow-up visit,106(16%)developed incident cognitive *** with,versus those without,hearing loss were significantly more likely to develop incident cognitive impairment at one year(adjusted OR=1.68,95%CI:1.07–2.64).Conclusions Hearing loss is a prevalent but under-recognized factor associated with cognitive impairment in patients with *** for hearing loss may be indicated among these patients to identify individuals at high-risk for adverse outcomes.

关键词： Atrial fibrillation Cognitive function Hearing

How Could Evidence-Based Reform Advance Education?

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ECNU Review of Education 2021年第1期4卷 7-24页

作者： robert E.Slavin alan C.K.Cheung Tengteng Zhuang Johns Hopkins University The Chinese University of Hong Kong Beijing Normal University

Purpose:This article presents a definition and rationale for evidence-based reform in education,and a discussion of the current state of evidence-based research,focusing on China,the U.S.,and the ***/Approach/Methods:The article contrasts the state of educational research in the U.S.,the UK,and China,world leaders in evidence-based ***:The article suggests ways in which Chinese,U.S.,UK,and other scholars might improve the worldwide quality of evidence-based reform in *** indicator of this partnership is an agreement among the Chinese University of Hong Kong,Nanjing Normal University,and Johns Hopkins University to work together on Chinese and English versions of the website Best Evidence in Brief and a collaboration between Johns Hopkins and the ECNU Review of Education at East China Normal ***/Value:This article is the first to compare developments in evidence-based reform in education in China with parallel developments in the *** UK Building understanding of current evidence-based policies should help all countries learn how evidence can play a greater role in education policy and benefit many students.

关键词： Evidence-based reform in education experiments international comparisons meta-analysis research designs

Evaluation of endocrine disruption and dioxin-like effects of organic extracts from sewage sludge in autumn in Beijing, China

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Frontiers of Environmental Science & Engineering 2014年第3期8卷 433-440页

作者： Cao LIU Yiping XU Mei MA Bingbin HUANG Jingdong WU Qingyi MENG Zijian WANG robert alan GEARHEART State Key Laboratory of Environmental Aquatic Chemistry Research Center for Eco-Environmental Sciences Chinese Academy of Sciences Beijing 100085 China Beijing Water Science and Technology Institute Beijing 100048 China Environmental Engineering Department Humboldt State University Arcata CA95521 USA

Study on effective disposal and utilization of sewage sludge has recently been the target of growing interest in China. However, potential risks are associated with the use of sludge due to its contamination with toxic organics, heavy metals and pathogenic microorganisms. In this study, a screening assessment was conducted on sewage sludge samples collected from 17 different sewage treatment plants in Beijing, based on a batch of in vitro bioassays, including a set of recombinant gene yeast assays for endocrine disruption, and an ethoxy resorufin-O- deethylase （EROD） assay using H4IIE cells for aryl hydrocarbon receptor （Ah-R） agonistic activities. Our results suggested that moderate levels of estrogen receptor agonistic activities （0.9 ng E2. g-1 to 6.8 ng E2. gl, dw）, but relative higher androgen receptor antagonistic activ- ities （nd to 45%）, progestin receptor antagonistic activities （nd to 80%） and Ah-R agonistic activities （1390 to 6740 pg 2,3,7,8-tetrachlorodibenzo-p-dioxin （TCDD）·g-1, dw） were found in sewage sludge samples. However, there were no significant correlations between the toxic effects of sewage sludge and the sewage treatment processes. In addition, the 17β-estradiol （E2） equivalent quantity （EEQ） level of the sewage sludge was increased after the composting treatment, whereas the 2,3,7,8-tetrachlorodi- benzo-p-dioxin toxic equivalent quantity （TEQ） level of sewagesludge composted was much lower than that of sewage sludge.

关键词： sewage sludge in vitro bioassay endocrine disruption dioxin-like effect

Temporal clinical, proteomic, histological and cellular immune responses of dextran sulfate sodium-induced acute colitis

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World Journal of Gastroenterology 2018年第38期24卷 4341-4355页

作者： Natalia Schneider Nunes Saejeong Kim Maggie Sundby Parwathy Chandran Scott robert Burks Ana Helena Paz Joseph alan Frank Frank Laboratory Radiology and Imaging Sciences Clinical Center National Institutes of Health Gastroenterology and Hepatology Sciences Graduate Program Universidade Federal do Rio Grande do Sul National Institute of Biomedical Imaging and Bioengineering National Institutes of Health

AIM To investigate the temporal clinical, proteomic, histological and cellular immune profiles of dextran sulfate sodium(DSS)-induced acute *** Acute colitis was induced in C57 BL/6 female mice by administration of 1%, 2% or 3% DSS in drinking water for 7 d. Animals were monitored daily for weight loss, stool consistency and blood in the stool, while spleens and colons were harvested on day 8. A time course analysis was performed in mice ingesting 3% DSS, which included colon proteomics through multiplex assay, colon histological scoring by a blinded investigator, and immune response through flow cytometry or immunohistochemistry of the spleen, mesenteric lymph node and *** Progressive worsening of clinical colitis was observed with increasing DSS from 1% to 3%. In mice ingesting 3% DSS, colon shortening and increase in proinflammatory factors starting at day 3 was observed, with increased spleen weights at day 6 and day 8. This coincided with cellular infiltration in the colon from day 2 to day 8, with progressive accumulation of macrophages F4/80^+, T helper CD4^+(Th), T cytotoxic CD8^+(Tcyt) and T regulatory CD25^+(Treg) cells, and progressive changes in colonic pathology including destruction of crypts, loss of goblet cells and depletion of the epithelial barrier. Starting on day 4, mesenteric lymph node and/or spleen presented with lower levels of Treg, Th and Tcyt cells, suggesting an immune cell tropism to the gut. CONCLUSION These results demonstrate that the severity of experimental colitis is dependent on DSS concentration, correlated with clinical, proteomic, histological and cellular immune response on 3% DSS.

关键词： Ulcerative colitis Dextran sulfate sodium Proteomics Inflammatory bowel diseases Inflammation

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为何富者愈富

财会月刊（合订本） 2003年第1C期 57-58,59页

作者： Herb goldberg robert Lewis 邓涛戴冰美

有一句古话:用一百块钱去挣一百万,让人不可思议;但以一百万再生一百万,则是顺理成章。总之,富人愈富的几率比穷人或中产阶级人士变富的几率大得多。以钱生钱赚钱的方法很多,但几乎所有能赚大钱而又合法的手段都和投资有关。你可以投... 详细信息

有一句古话:用一百块钱去挣一百万,让人不可思议;但以一百万再生一百万,则是顺理成章。总之,富人愈富的几率比穷人或中产阶级人士变富的几率大得多。以钱生钱赚钱的方法很多,但几乎所有能赚大钱而又合法的手段都和投资有关。你可以投资房地产、股票、彩票或做生意,但不管你通过何种方法去发财致富,前提是必须有本钱。正如卢梭在两百多年前就看透的:“钱能生钱。

关键词：投资个人财富资本积累收入水平