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Absolute cardiovascular risk assessment by Australian early-career general practitioners: a cross-sectional study

Family Medicine and Community Health 2023年第3期11卷 45-61页

作者： Toby Morgan Anna Ralston Andrew Davey Elizabeth G Holliday Mark Nelson Alison Fielding Mieke van Driel Amanda Tapley Dominica Moad Jean Ball Jennifer Presser Neil Spike Parker Magin School of Population Health University of New South Wales Faculty of MedicineKensingtonNew South WalesAustralia NSW&ACT Research and Evaluation Unit GP Synergy Ltd-NewcastleMayfield WestNew South WalesAustralia School of Medicine and Public Health The University of NewcastleCallaghanNew South WalesAustralia University of Tasmania Menzies Institute for Medical Research HobartTasmaniaAustralia University of Tasmania School of Medicine HobartTasmaniaAustralia general practice Clinical Unit The University of Queensland Faculty of MedicineBrisbaneQueenslandAustralia Clinical Research Design and Statistical Support Unit(CReDITSS) The University of Newcastle Hunter Medical Research InstituteNew LambtonNew South WalesAustralia Department of general practice and Primary Health Care The University of MelbourneCarltonVictoriaAustralia Monash University Faculty of Medicine Nursing and Health Sciences ClaytonVictoriaAustralia

Objective To determine the prevalence and associations of general practice registrars’performing absolute cardio-vascular risk(ACVR)assessment(ACVRa).Design A cross-sectional study employing data(2017–2018)from the Registrar Clinical Encounters in training project,an ongoing inception cohort study of Australian GP *** outcome measure was whether an ACVRa was *** employed univariable and multivariable *** was conducted for all patient problems/diagnoses,then for an‘at-risk’population(specific problems/diagnoses for which ACVRa is indicated).Setting Three GP regional training organisations(RTOs)across three Australian *** GP registrars training within participating *** 1003 registrars(response rate 96.8%)recorded details of 69105 problems either with Aboriginal and/or Torres Strait patients aged 35 years and older or with non-Indigenous patients aged 45 years and *** these problems/diagnoses,1721(2.5%(95%CI 2.4%to 2.6%))involved an *** ACVRa was‘plausibly indicated’in 10384 problems/*** these,1228(11.8%(95%CI 11.2%to 12.4%))involved ***‘all problems/diagnoses’,on multivariable analysis female gender was associated with reduced odds of ACVRa(OR 0.61(95%CI 0.54 to 0.68)).There was some evidence for Aboriginal and/or Torres Strait Islander people being more likely to receive ACVRa(OR 1.40(95%CI 0.94 to 2.08),p=0.10).There were associations with variables related to continuity of care,with reduced odds of ACVRa:if the patient was new to the registrar(OR 0.65(95%CI 0.57 to 0.75)),new to the practice(OR 0.24(95%CI 0.15 to 0.38))or the problem was new(OR 0.68(95%CI 0.59 to 0.78));and increased odds if personal follow-up was organised(OR 1.43(95%CI 1.24 to 1.66)).For‘ACVRa indicated’problems/diagnoses,findings were similar to those for‘all problems/diagnoses’.Association with Aboriginal and/or Torres Strait Islander status,however,was significant at p<0.05(OR 1.60(95%CI 1.04 to 2.46))a

关键词： sectional continuity Island

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Endovascular thrombectomy for stroke: current best practice and future goals

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Stroke & Vascular Neurology 2016年第1期1卷 16-22页

作者： Bruce C V Campbell Geoffrey A Donnan Peter J Mitchell Stephen M Davis Department of Medicine and Neurology Melbourne Brain Centre at the Royal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaAustralia The Florey Institute of Neuroscience and Mental Health University of MelbourneParkvilleVictoriaAustralia Department of Radiology Royal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaAustralia

Endovascular thrombectomy for large vessel ischaemic stroke substantially reduces disability,with recent positive randomised trials leading to guideline changes *** review discusses in detail the evidence provided by recent randomised trials and metaanalyses,the remaining areas of uncertainty and the future directions for *** data from existing trials have demonstrated the robust benefit of endovascular thrombectomy for internal carotid and proximal middle cerebral artery *** remains for more distal occlusions where the efficacy of alteplase is greater,less tissue is at risk and the safety of endovascular procedures is less *** artery occlusion was excluded from the trials,but with a dire natural history and proof of principle that rapid reperfusion is effective,it seems reasonable to continue treating these patients pending ongoing trial *** has been no evidence of heterogeneity in treatment effect in clinically defined subgroups by age,indeed,those aged>80 years have at least as great an overall reduction in disability and reduced *** there was no heterogeneity across the range of baseline stroke severities included in the *** that routine use of general anaesthesia reduces the benefit of endovascular thrombectomy is increasing and conscious sedation is generally preferred unless severe agitation or airway compromise is *** impact of time delays has become clearer with description of onset to imaging and imaging to reperfusion *** in the onset to imaging reduce the proportion of patients with salvageable brain ***,in the presence of favourable imaging,rapid treatment appears beneficial regardless of the onset to imaging time *** to reperfusion delays lead to decay in the clinical benefit achieved,particularly in those with less robust collateral *** brain imaging options to assess prognosis have various advantages and disadvan

关键词： routine epoch benefit

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TCM in Canada:Health Care and the Importance of Alternative Medicines that Complement Medical practice

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Chinese Medicine and Culture 2022年第4期5卷 216-220页

作者： HonoréFrance University of victoria Victoria V8P 5C2Canada

This article explores the introduction and growth of traditional Chinese medicine(TCM)through the lens of Chinese immigration to *** further explores how it has spread to other cultural groups in *** theories are described to explain why it has attracted attention by non-Chinese ethnicities:the interest in organic and nature-based approaches,the underfunding health care,lack of family doctors,expensive drugs from big pharmaceutical companies,and respect for Chinese cultural *** regulatory practice of TCM is described along with the organization,types of educational program and certification as well as a patient’s perspective of TCM treatment.

关键词： Canada Chinese immigration Education Patient’s perspective Regulatory system Theories of growth in non-Chinese patients

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Do lifestyle changes work for improving erectile dysfunction？

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Asian Journal of Andrology 2008年第1期10卷 28-35页

作者： Kaya Horasanli Ugur Boylu Muammer Kendirci Cengiz Miroglu The Second Urology Department Sisli Etfal Training and Research Hospital Sisli-34377 Istanbul Turkey

The main cause of erectile dysfunction （ED） is organic in nature, with vascular etiologies being the most common risk factors. Although there have been sufficient data on the relationship between ED and several well-recognized risk factors, including aging, coronary artery disease, atherosclerosis, diabetes mellitus, dyslipidemia, high blood pressure, and pelvic surgeries, little attention has been paid by the urologists to the role of lifestyle factors in ED. However, accumulating data from basic science and clinical studies have determined a link between the occurrence of ED and a number of lifestyle factors, such as smoking, obesity, alcohol consumption, and lack of physical activity. The application of findings from animal and human studies to the clinical practice regarding the modification of lifestyle factors could help improving ED as well as reducing the risks of developing cardiovascular diseases. This communication addresses the impact of lifestyle factors on erectile function and the potential benefits of modifying these factors to improve ED in respect to the current evidence.

关键词： erectile dysfunction lifestyle smoking obesity alcohol sedentary life

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A Conditional Generative adversarial Network for energy use in multiple buildings using scarce data

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Energy and AI 2021年第3期5卷 119-132页

作者： Gaby Baasch Guillaume Rousseau Ralph Evins Energy and Cities Group Department of Civil EngineeringUniversity of VictoriaCanada

Building consumption data is integral to numerous applications including retrofit analysis,Smart Grid integration and optimization,and load ***,due to technical limitations,privacy concerns and the proprietary nature of the industry,usable data is often unavailable for research and *** adversarial networks(GANs)-which generate synthetic instances that resemble those from an original training dataset-have been proposed to help address this *** studies use GANs to generate building sequence data,but the models are not typically designed for time series problems,they often require relatively large amounts of input data(at least 20,000 sequences)and it is unclear whether they correctly capture the temporal behaviour of the *** this work we implement a conditional temporal GAN that addresses these issues,and we show that it exhibits state-of-the-art performance on small datasets.22 different experiments that vary according to their data inputs are benchmarked using Jensen-Shannon divergence(JSD)and predictive forecasting validation *** these,the best performing is also evaluated using a curated set of metrics that extends those of previous work to include PCA,deep-learning based forecasting and measurements of trend and *** case studies are included:one for residential and one for commercial *** model achieves a JSD of 0.012 on the former data and 0.037 on the latter,using only 396 and 156 original load sequences,respectively.

关键词： Generative adversarial network Building load profile Machine learning Data scarcity

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Adjuvant therapies for colorectal cancer

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World Journal of Gastroenterology 2007年第28期13卷 3799-3805页

作者： Suzanne Kosmider Lara Lipton Department of Medical Oncology and Clinical Haematology Western HospitalFootscray 3011VictoriaAustralia

The management of colon and rectal cancer has changed dramatically over the last 25 years. The use of adjuvant therapies has become standard practice in locally advanced （stage M and selected stage 11） colorectal cancer. Improved surgical techniques, chemotherapeutics and radiotherapy are resulting in higher cure rates and the development of agents targeting proliferative and angiogenic pathways offer further promise. Here we explore risk factors for local and distant recurrence after resection of colon and rectal cancer, and the role of adjuvant treatments. Discussion will focus on the evidence base for adjuvant therapies utilised in colorectal cancer, and the treatment of sub-groups such as the elderly and stage 11 disease. The role of adjuvant radiotherapy in rectal cancer in reduction of recurrence will be explored and the role and optimal methods for surveillance post-curative resection with or without adjuvant therapy will also be addressed.

关键词： Colon cancer Rectal cancer Chemotherapy Radiotherapy Adjuvant treatment

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Characterization of mechanical properties for tubular materials based on hydraulic bulge test under axial feeding force

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Fundamental Research 2023年第4期3卷 592-601页

作者： Bin Zhang Benny Endelt Karl Brian Nielsen Department of Materials and Production Aalborg UniversityAalborg 9220Denmark Engineering Teaching practice training Center Tiangong UniversityTianjin 300387China Research and Development Lab Vestas aircoil A/SLem 6940Denmark Department of Mechanical and Production Engineering Aarhus UniversityAarhus 8000Denmark

A T-shape tube hydraulic bulge test under axial feeding force is carried out to characterize the mechanical properties of EN AW 5049-O and 6060-O aluminium *** punch displacement,T-branch height and axial compressive force are recorded online during the *** intelligent inverse identification framework combining the finite element method and numerical optimization algorithm is developed to determine material parameters by fitting simulated results to the experimental data *** identified constitutive parameters using the inverse modelling technique are compared with those determined by the theoretical analysis and uniaxial tensile *** comparison shows that the predicted bulge height and punch force based on the material parameters obtained by the three methods are different and the inverse strategy produces the smallest gap between numerical and experimental *** is possible to conclude that the hydraulic bulge test can be applied to characterize the stress-strain curve of tubular materials at the large strain scope,and the automatic inverse framework is a more accurate post-processing procedure to identify material constitutive parameters compared with the classical analytical model.

关键词： Intelligent optimization Tubular material Parameter identification Hydraulic bulge test Constitutive model

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Active sorting of orbital angular momentum states of light with a cascaded tunable resonator

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Light(Science & Applications) 2020年第1期9卷 1904-1913页

作者： Shibiao Wei Stuart K.Earl Jiao Lin Shan Shan Kou Xiao-Cong Yuan Nanophotonics Research Center Shenzhen Key Laboratory of Micro-Scale Optical Information TechnologyShenzhen UniversityShenzhen 518060China Department of Chemistry and Physics La Trobe Institute for Molecular Science(LIMS)La Trobe UniversityVictoria 3086Australia School of Engineering RMIT UniversityMelbourneVictoria 3001Australia School of Physics The University of MelbourneTin AlleyMelbourneVictoria 3010Australia

The orbital angular momentum(OAM)of light has been shown to be useful in diverse fields ranging from astronomy and optical trapping to optical communications and data ***,one of the primary impediments preventing such applications from widespread adoption is the lack of a straightforward and dynamic method to sort incident OAM states without altering the ***,we report a technique that can dynamically filter individual OAM states and preserve the incident OAM states for subsequent *** the working principle of this technique is based on resonance,the device operation is not limited to a particular *** states with different wavelengths can resonate in the resonator without any additional modulation other than changing the length of the ***,we are able to demonstrate a reconfigurable OAM sorter that is constructed by cascading such optical *** approach does not require specially designed components and is readily amenable to integration into potential applications.

关键词： resonator tunable momentum

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Dynamic Changes of Chemical and Mechanical Properties of Moso Bamboo (Phyllostachys edulis) Culms under Different Storage Conditions

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Journal of Renewable Materials 2021年第5期9卷 1031-1043页

作者： Hui Zhan Zhaohui Niu Lixia Yu Maobiao Li Changming Wang Shuguang Wang Southwest Forestry University Kunming650224China APFNet Kunming training Center Kunming650224China

The durability of bamboo based on its chemical and mechanical properties is a crucial consideration for the wood-based industry due to its vulnerability to insects and *** investigated the dynamic changes of chemical and mechanical properties of Phyllostachys edulis under air-dry and water storage conditions for 3,6 and 12 months *** chemical properties of *** bamboo culms varied with culm age but insignificantly with culm *** mechanical properties of *** culms showed an increasing trend with culm *** storage condition decreased the ash,SiO2 and lignin content,but increased the ethanol-benzene *** also created an anaerobic environment for bamboo culms in which only anaerobic respiration was possible contributing to reducing the content of soluble sugar and starch,thereby beneficial for decreasing the damage from insects and ***,the water storage conditions could maintain culm mechanical performance ***,the indigenous practice of local people to store bamboo culms in ponds has good science behind it and water storage practices of bamboo culms was recommended.

关键词： Phyllostachys edulis chemical properties mechanical properties storage conditions

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Perianal Crohn’s disease:Still more questions than answers

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World Journal of Gastroenterology 2024年第39期30卷 4260-4266页

作者： Akhilesh Swaminathan Miles P Sparrow Department of Medicine University of OtagoChristchurch 8011CanterburyNew Zealand Department of Gastroenterology Alfred HealthMelbourne 3004VictoriaAustralia Department of Gastroenterology The Alfred HospitalMelbourne 3004VictoriaAustralia Department of Gastroenterology Alfred Health and School of Translational MedicineMonash UniversityMelbourne 3004VictoriaAustralia

In this editorial we comment on the article by Pacheco et al published in a recent issue of the World Journal of *** focus specifically on the burden of illness associated with perianal fistulizing Crohn’s disease(PFCD)and the diagnostic and therapeutic challenges in the management of this ***-ving evidence has shifted the diagnostic framework for PFCD from anatomical classification systems,to one that is more nuanced and patient-focused to drive ongoing decision *** editorial aims to reflect on these aspects to help clinicians face the challenge of PFCD in day-to-day clinical practice.

关键词： Perianal Crohn’s disease Crohn’s disease classification Disease severity Crohn’s disease treatment Anorectal malignancy

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