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First-line endoscopic treatment with over-the-scope clips significantly improves the primary failure and rebleeding rates in high-risk gastrointestinal bleeding: A single-center experience with 100 cases

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World journal of Gastroenterology 2016年第41期22卷 9162-9171页

作者： Hans-jürgen Richter-Schrag Torben Glatz Christine Walker Andreas Fischer robert Thimme Center of Interdisciplinary Gastrointestinal Endoscopy Department of Medicine II Medical Center-University of Freiburg Faculty of Medicine University of Freiburg Department of General and Visceral Surgery Medical Center-University of Freiburg Faculty of Medicine University of Freiburg

AIM To evaluate rebleeding, primary failure(PF) and mortality of patients in whom over-the-scope clips(OTSCs) were used as first-line and second-line endoscopic treatment(FLET, SLET) of upper and lower gastrointestinal bleeding(UGIB, LGIB).METHODS A retrospective analysis of a prospectively collected database identified all patients with UGIB and LGIB in a tertiary endoscopic referral center of the University of Freiburg, Germany, from 04-2012 to 05-2016(n= 93) who underwent FLET and SLET with OTSCs. The complete Rockall risk scores were calculated from patients with UGIB. The scores were categorized as < or ≥ 7 and were compared with the original Rockall data. Differences between FLET and SLET were calculated. Univariate and multivariate analysis were performed to evaluate the factors that influenced rebleeding after OTSC *** Primary hemostasis and clinical success of bleeding lesions(without rebleeding) was achieved in 88/100(88%) and 78/100(78%), respectively. PF was significantly lower when OTSCs were applied as FLET compared to SLET(4.9% vs 23%, P = 0.008). In multivariate analysis, patients who had OTSC placement as SLET had a significantly higher rebleeding risk compared to those who had FLET(OR 5.3; P = 0.008). Patients with Rockall risk scores ≥ 7 had a significantly higher in-hospital mortality compared to those with scores < 7(35% vs 10%, P = 0.034). No significant differences were observed in patients with scores < or ≥ 7 in rebleeding and rebleeding-associated *** Our data show for the first time that FLET with OTSC might be the best predictor to successfully prevent rebleeding of gastrointestinal bleeding compared to SLET. The type of treatment determines the success of primary hemostasis or primary failure.

关键词： Gastrointestinal bleeding Rockall risk score Over-the-scope clip First-line endoscopic treatment Second-line endoscopic treatment

Multiple mechanisms in woodland plant species invasion

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journal of Plant Ecology 2019年第2期12卷 201-209页

作者： robert j.Warren II Matt Candeias Adam Labatore Michael Olejniczak Lin Yang Department of Biology SUNY Buffalo State1300 Elmwood AvenueBuffaloNY 14222USA Department of Natural Resources University of IllinoisW-503 Turner Hall 1102 South Goodwin AveUrbanaIL 61801USA US Army Corps of Engineers 441 G Street NWWashingtonDC 20314-1000USA

Aims A plethora of theories explain species invasion,yet when tested in isolation,support or falsification becomes contingent on study species,system and *** objective was to examine com-munity-level species invasion as a function of multiple competing *** We used data from>3500 woodland plant species in 2750 plots in 49 national parks in eastern US deciduous forests to test multiple competing theories of species invasion:competition,empty niche,propagule pressure and latitude *** also tested interac-tions with residence time to account for non-native species naturali-zation and spread since *** Findings The non-native herbs generally thrived at latitudes similar to those from which they originated,but not necessarily where they were originally introduced to the eastern ***,we found that each hypothesis explained at least some aspect of woodland plant species invasion,but examining them simultaneously allowed assessment of their relative strengths and *** results suggested that residence time is a strong predictor of non-native woodland plant success,particularly as it interacts with other mechanisms of inva-sion,such as competition(abundance of native woodland plants),climate matching(similar invaded latitude as home range),prop-agule pressure(distance to putative seed sources)and empty niche(relatedness to native plants).We found that initial barriers,such as distance from propagule source or suboptimal habitat,were over-come,as was resistance from native ***,the biggest challenge for the non-native woodland plants appeared to be time,as they declined after~1 to 2 centuries.

关键词： competition empty niche invasion biology propagule pressure latitude matching residence time

Fish oil-based lipid emulsion:current updates on a promising novel therapy for the management of parenteral nutrition-associated liver disease

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Gastroenterology Report 2015年第2期3卷 110-114页

作者： Shishira Bharadwaj Tushar Gohel Omer j.Deen robert DeChicco Abdullah Shatnawei Center for Human Nutrition Department of Gastroenterology/HepatologyThe Cleveland Clinic FoundationClevelandOHUSA

Intestinal failure is characterized by loss of enteral function to absorb necessary nutrients and water to sustain *** nutrition(PN)is a lifesaving therapeutic modality for patients with intestinal *** PN is also needed for patients who have short bowel syndrome due to extensive resection or a dysmotility disorder with ***,prolonged PN is associated with short-term and long-term *** nutrition-associated liver disease(PNALD)is one of the long-termcomplications associated with the use of an intravenous lipid emulsion to prevent essential fatty acid deficiency in these *** affects 30–60%of the adult population on long-term ***,PNALD is one of the indications for isolated liver or combined liver and intestinal *** is no consensus on how to manage PNALD,but fish oil-based lipid emulsion(FOBLE)has been suggested to play an important role both in its prevention and *** is significant improvement in liver function in those who received FOBLE as lipid supplement compared with those who received soy-based lipid *** have also demonstrated that FOBLE reverses hepatic steatosis and reduces markers of inflammation in patients on long-term *** prospective studies with larger sample sizes are needed to further strengthen the positive role of FOBLE in PNALD.

关键词： intestinal failure parenteral nutrition parenteral nutrition-associated liver disease fish oil-based lipid emulsion

Innovations in Agriculture and Food Supply in Response to the COVID-19 Pandemic

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Molecular Plant 2020年第8期13卷 1095-1097页

作者： robert Henry Queensland Alliance for Agriculture and Food Innovation University of QueenslandBrisbaneQLD 4072 Australia

In human history,the long-term expansion of populations has been limited by the availability of food and constraints of disease(Diamond,1997).The domestication of plants and animals has facilitated the development of human societies,and the resulting larger human populations have increased the risk of major disease outbreaks(pandemics).The recent COVID-19 pandemic resulted from the emergence of a disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).This has caused major disruption to economic activity with severe restrictions on international *** impact on agriculture and global food security will be complex(Torero,2020),and many of the consequences are yet to be identified and understood(jámbor et al.,2020).Despite growing stocks of foods such as cereals(FAO,2020),it has been estimated that the number of people facing a food crisis will grow from 135 million to 265 million by the end of 2020(Anthem,2020;Figure 1).The pandemic has added to the food security challenges posed by climate change and major conflicts,both of which have been major factors contributing to recent food *** scientists need to determine how investment in innovation needs to change in response to the *** about shortages of labor and food safety will intensify efforts to use automation at all stages in the food production system to ensure supply.

关键词： Figure travel consequences

Assessing the migratory histories, trophic positions, and conditions of lake sturgeon in the St. Croix and Mississippi Rivers using fn ray microchemistry, stable isotopes, and fatty acid profles

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Ecological Processes 2021年第1期10卷 1021-1042页

作者： jefrey R.Ziegeweid Michelle R.Bartsch Lynn A.Bartsch Steven j.Zigler robert j.Kennedy Seth A.Love U.S.Geological Survey California Water Science Center6000 J StPlacer HallSacramentoCA 95819USA. U.S.Geological Survey Upper Midwest Water Science Center2280 Woodale DrMounds ViewMN 55112USA. U.S.Geological Survey Upper Midwest Environmental Sciences Center2630 Fanta Reed RoadLa CrosseWI 54603USA. Division of Fisheries Illinois Department of Natural Resources13608 Fox RoadYorkvilleIL 60560USA.

Background:Reproducing populations of invasive carps(Hypophthalmichthys spp.)could alter aquatic food webs and negatively afect native fshes in the Mississippi National River and Recreation Area(MISS)and the *** National Scenic Riverway(SACN).However,proposed invasive carp barriers may also threaten populations of native migratory fshes by preventing movements of fsh between rivers that are necessary for life history *** this study,nonlethal chemical techniques were used to provide baseline data related to the condition,trophic position,and migratory histories of lake sturgeon(Acipenser fulvescens)captured in the Mississippi and *** ***:Fish length and weight measurements and age estimates determined from pectoral fn rays demonstrated that lake sturgeon from the Mississippi River had greater lengths-at-age compared to sturgeon from the *** ***,length–weight relations were similar for sturgeon from the Mississippi and *** *** sturgeon captured from diferent locations had distinguishable fatty acid signatures,and stable isotope analyses demonstrated that lake sturgeon from the Mississippi River generally feed at a higher trophic level than those in the *** ***-to-calcium ratios(Sr:Ca)from fn ray cross sections indicated that sturgeon captured from the Mississippi River had higher Sr:Ca values than sturgeon captured from the *** River,and natal origins and capture locations were not signifcantly diferent among sturgeon captured within individual *** sturgeon were captured in water with a similar Sr:Ca signature as their natal waters,indicating that there is some separation between populations of lake sturgeon in the *** and Mississippi ***,Sr:Ca data indicated substantial variation in movement patterns among individual lake sturgeon,indicating that populations interact through migrations of individual fsh between ***:Study results provide baseline c

关键词： Fin ray microchemistry Stable isotopes Fatty acids Lake sturgeon St.Croix River Mississippi River National park Strontium Calcium

A plant-based diet and heart failure： case report and literature review

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journal of Geriatric Cardiology 2017年第5期14卷 375-378页

作者： Evan Y Choi Kathleen Allen Michael McDonnough Daniele Massera robert j Ostfeld Department of Medicine Montefiore Medical Center Bronx NY USA Department of Nutrition & Food Studies New York University NY NY USA Department of Nutrition New York-Presbyterian Hospital NY NY USA Division of Cardiology Montefiore Medical Center Bronx NY USA

Heart failure is associated with high rates of morbidityand mortality, and is a burden to the healthcare *** is a growing appreciation for the role diet may play inthe development and treatment of heart failure.

关键词： Heart failure Lifestyle Plant-based diet Vegetarian

Modern short stories in English New rev. ed.

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Effect of clonidine on the cutaneous silent period during spinal anesthesia

丛书名： 89 p. :

1000年

作者： robert j. Dixson.

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World journal of Clinical Cases 2018年第16期6卷 1136-1145页

作者： Sandra graf Zupcic Miroslav Zupcic Viktor Duzel Tatjana imurina Milan Miloevi Silvio Basic Vladimira Vuletic Leonardo Kapural Clinic of Neurology Clinical Hospital Centre Rijeka Faculty of Medicine J.J.Strossmayer University Clinic of Anesthesiology and Intensive Care Medicine Clinical Hospital Centre Rijeka Faculty of Medicine University of Rijeka Department of Anaesthesia Barking Havering and Redbridge University Hospitals NHS Trust Department of Health Studies University of Zadar Department of Anesthesiology and Intensive Care Medicine General Hospital Zadar University of Zagreb School of Medicine Andrija Stampar School of Public Health WHO Collaborative Centre for Occupational Health Department of Neurology Clinical Hospital Dubrava Center for Clinical Research Winston Salem

AIM To investigate the effect of clonidine on the cutaneous silent period(CSP) during spinal anesthesia. METHODS A total of 67 adult patients were included in this randomized, prospective, single-center, double-blind trial. They did not have neurological disorders and were scheduled for inguinal hernia repair surgery. This trial was registered on ***(NTC03121261). The patients were randomized into two groups with regards to the intrathecally administered solution:(1) 15 mg of 0.5% levobupivacaine with 50 μg of 0.015% clonidine, or(2) 15 mg of 0.5% levobupivacaine alone. There were 34 patients in the levobupivacaine-clonidine(LC) group and 33 patients in the levobupivacaine(L) group. CSP and its latency were measured four times: prior to the subarachnoid block(SAB), after motor block regression to the 0 level of the Bromage scale, with ongoing sensory blockade, and both 6 and 24 h after *** Only data from 30 patients in each group were analyzed. There were no significant differences between the groups investigated preoperatively and after 24 h. The CSP of the L group at the time point when the Bromage scale was 0 was 44.8 ± 8.1 ms, while in the LC group it measured 40.2 ± 3.8 ms(P = 0.007). The latency in the L group at the time point when the Bromage scale was 0 was 130.3 ± 10.2 ms, and in the LC group it was 144.7 ± 8.3 ms(P < 0.001). The CSP of the L group after 6 h was 59.6 ± 9.8 ms, while in the LC group it was 44.5 ± 5.0 ms(P < 0.001). The latency in the L group after 6 h was 110.4 ± 10.6 ms, while in LC group it was 132.3 ± 9.7 ms(P < 0.001).CONCLUSION Intrathecal addition of clonidine to levobupivacaine for SAB in comparison with levobupivacaine alone resultsin a diminished inhibitory tonus and shortened CSP.

关键词： Clonidine Local anesthetics Nerve fibers Spinal anesthesia Reflex

Online single-session interventions for Kenyan adolescents:study protocol for a comparative effectiveness randomised controlled trial

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General Psychiatry 2021年第3期34卷 163-168页

作者： Akash R Wasil Tom Lee Osborn john R Weisz robert j DeRubeis Department of Psychology University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Shamiri Institute NairobiKenya Department of Psychology Harvard UniversityCambridgeMassachusettsUSA

Background Mental health problems are the leading cause of disability among adolescents worldwide,yet access to treatment is *** digital interventions have been shown to improve youth mental health,but little is known about which digital interventions are most *** To evaluate the effectiveness of two digital single-session interventions(Shamiri-Digital and Digital-CBT(cognitive-behavioural therapy))among Kenyan *** We will perform a school-based comparative effectiveness randomised controlled *** 926 Kenyan adolescents will be randomly assigned to one of three conditions:Shamiri-Digital(focused on gratitude,growth mindsets and values),Digital-CBT(focused on behavioural activation,cognitive restructuring and problem solving)or a study-skills control condition(focused on note-taking and essay writing skills).The primary outcomes include depressive symptoms(measured by the Patient Health Questionnaire-8),anxiety symptoms(Generalized Anxiety Disorder Screener-7)and subjective well-being(Short Warwick-Edinburgh Mental Well-being Scale).The secondary outcomes include acceptability,appropriateness,primary control and secondary *** and appropriateness will be measured immediately post-intervention;other outcomes will be measured 2 weeks,4 weeks and 12 weeks *** We hypothesise that adolescents assigned to Shamiri-Digital and adolescents assigned to Digital-CBT will experience greater improvements(assessed via hierarchical linear models)than those assigned to the control *** will also compare Shamiri-Digital with Digital-CBT,although we do not have a preplanned *** Our findings will help us evaluate two digital single-session interventions with different theoretical *** effective,such interventions could be disseminated to reduce the public health burden of common mental health problems.

关键词： assigned behaviour Edinburgh