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Fatalities caused by novel opioids:a review

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Forensic sciences Research 2019年第2期4卷 95-110页

作者： Olaf H.Drummer Department of Forensic medicine School of Public Health and Preventive MedicineFaculty of MedicineNursing and Health SciencesMonash UniversitySouthbankVictoriaAustralia

Drugs related to morphine represent not only large range of important therapeutic applications for the relief of moderate to severe pain but also give rise to a relatively large series of novel opioids that mimic the action of this naturally occurring *** of these are based on fentanyl structures that are much more potent,and dangerous,than fentanyl *** publication reviews reports of fatalities attributed to 15 novel opioids with the view to assessing mortality associated with their misuse as well as reviewing published analytical procedures that would be able to detect these and other novel *** drugs include reports of deaths to acetylfentanyl,acrylfentanyl,butr(yl)fentanyl,carfentanil,2-and 4-fluorofentanyls,4-fluorobutyrfentanyl,4-fluoroisobutyrfentanyl,furanylfentanyl,a-and 3-methylfentanyls,4-methoxyfentanyl,ocfentanil,as well as AH-7921,U-47700 and *** of these cases reporting a drug-caused death involved other drugs in addition to the *** obvious minimum fatal concentration was discerned for any of the opioids for which details were provided,however,the more potent members required detection limits well under 1 ng/mL and often even well below 0.1 ng/mL requiring use of the most sensitive mass spectral detection procedures,particularly when screening specimens using a non-targeted *** other novel opioids have been reported in admissions to hospitals include 4-chloroisobutryfentanyl,cyclopentylfentanyl and tetrahydrofuranfentanyl,all of which are likely to have the potential to cause *** is also likely that other analogues will appear with time.

关键词： Forensic science forensic toxicology opioids poisoning illicit drugs novel psychoactive drugs fentanyl derivatives mass spectrometry

Optogenetic neuroregeneration

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Neural Regeneration Research 2022年第7期17卷 1468-1470页

作者： Harald Janovjak Sonja Kleinlogel EMBL Australia Australian Regenerative Medicine InstituteFaculty of MedicineNursing and Health SciencesMonash UniversityClayton/MelbourneAustralia Institute of Physiology University of BernBernSwitzerland

Optogenetics is a powerful technology that employs light and genetics to manipulate physiology and behavior with unprecedented *** high acuity of light stimulation permits fine control both in space(e.g.,to target just one tissue in an animal)and in time(e.g.,to interfere with a specific disease stage),whilst genetic targeting restricts manipulation to a functionally-relevant cell population(Figure 1A).

关键词： stimulation manipulation Figure

Deep learning vs conventional learning algorithms for clinical prediction in Crohn's disease: A proof-of-concept study

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World Journal of Gastroenterology 2021年第38期27卷 6476-6488页

作者： Danny Con Daniel R van Langenberg Abhinav Vasudevan Department of Gastroenterology and Hepatology Eastern HealthBox Hill 3128VictoriaAustralia faculty of medicine Nursing and Health SciencesMonash UniversityBox Hill 3128VictoriaAustralia

BACKGROUND Traditional methods of developing predictive models in inflammatory bowel diseases(IBD)rely on using statistical regression approaches to deriving clinical scores such as the Crohn's disease(CD)activity ***,traditional approaches are unable to take advantage of more complex data structures such as repeated *** learning methods have the potential ability to automatically find and learn complex,hidden relationships between predictive markers and outcomes,but their application to clinical prediction in CD and IBD has not been explored *** To determine and compare the utility of deep learning with conventional algorithms in predicting response to anti-tumor necrosis factor(anti-TNF)therapy in *** This was a retrospective single-center cohort study of all CD patients who commenced anti-TNF therapy(either adalimumab or infliximab)from January 1,2010 to December 31,*** was defined as a C-reactive protein(CRP)<5 mg/L at 12 mo after anti-TNF *** supervised learning algorithms were compared:(1)A conventional statistical learning algorithm using multivariable logistic regression on baseline data only;(2)A deep learning algorithm using a feed-forward artificial neural network on baseline data only;and(3)A deep learning algorithm using a recurrent neural network on repeated *** performance was assessed using area under the receiver operator characteristic curve(AUC)after 10×repeated 5-fold *** A total of 146 patients were included(median age 36 years,48%male).Concomitant therapy at anti-TNF commencement included thiopurines(68%),methotrexate(18%),corticosteroids(44%)and aminosalicylates(33%).After 12 mo,64%had CRP<5 mg/*** conventional learning algorithm selected the following baseline variables for the predictive model:Complex disease behavior,albumin,monocytes,lymphocytes,mean corpuscular hemoglobin concentration and gamma-glutamyl transferase,and had a cross-valid

关键词： Machine learning Artificial intelligence Precision medicine Personalized medicine Deep learning

Barriers that practitioners face when initiating insulin therapy in general practice settings and how they can be overcome

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World Journal of Diabetes 2017年第1期8卷 28-39页

作者： Abdulaziz Bin rsheed Ian Chenoweth Department of Family and Community medicine Prince Sultan Military Medical City Department of General Practice School of Primary Health Care Faculty of MedicineNursing and Health Sciences Monash University

AIM To explore primary care physicians' perspectives on possible barriers to the use of *** This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eight electronic databases were searched(between January 1, 1994 and August 31, 2014) for relevant studies. A search for grey literature and a review of the references in the retrieved studies were also conducted. Studies that focused on healthcare providers' perspectives on possible barriers to insulin initiation with type 2 diabetic patients were included, as well as articles suggesting solutions for these barriers. Review articles and studies that only considered patients' perspectives were excluded. RESULTS A total of 19 studies met the inclusion criteria and were therefore included in this study: 10 of these studies used qualitative methods, 8 used quantitative methods and 1 used mixed methods. Studies included a range of different health care settings. The findings are reported under four broad categories: The perceptions of primary care physicians about the barriers to initiate insulin therapy for type 2 diabetes patients, how primary care physicians assess patients prior to initiating insulin, professional roles and possible solutions to overcome these barriers. The barriers described were many and covered doctor, patient, system and technological aspects. Interventions that focused on doctor training and support, or IT-based decision support were few, and did not result in significant improvement. CONCLUSION Primary care physicians' known delay in insulin initiation is multifactorial. Published reports of attempts to find solutions for these barriers were limited in number.

关键词： Diabetes Insulin Initiation Delay Barriers Primary care physicians

Acute-on-chronic liver failure: Controversies and consensus

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World Journal of Gastroenterology 2023年第2期29卷 232-240页

作者： Natalie L Y Ngu Eliza Flanagan Sally Bell Suong T Le Department of Gastroenterology and Hepatology Monash HealthClayton 3168VictoriaAustralia faculty of medicine Nursingand Health SciencesMonash UniversityClayton 3800VictoriaAustralia Department of Gastroenterology and Hepatology Alfred HealthMelbourne 3004VictoriaAustralia monash digital Therapeutics and Innovation Laboratory(MoTILa) Monash UniversityClayton 3168VictoriaAustralia

Acute-on-chronic liver failure(ACLF)is a poorly defined syndrome characterised by rapid clinical deterioration in patients with chronic liver *** include high short-term morbidity,mortality,and healthcare resource *** encompasses a dysregulated,systemic inflammatory response,which can precipitate extra hepatic organ *** precipitants include infection,alcoholic hepatitis,and reactivation of viral hepatitis although frequently no cause is *** definitions,diagnostic criteria,and treatment guidelines,have been proposed by international hepatology *** can result in delayed or missed diagnoses of ACLF,significant variability in clinical management,and under-estimation of disease *** transplantation may be considered but the mainstay of treatment is organ support,often in the intensive care *** review will provide clarity around where are the controversies and consensus in ACLF including:Epidemiology and resource utilisation,key clinical and diagnostic features,strategies for management,and research gaps.

关键词： Acute-on-chronic liver failure Liver cirrhosis End stage liver disease Epidemiology Mortality

Effects of COVID-19 fear and anxiety on attitudes towards complementary and alternative medicine use in women with gynecological cancer during the COVID-19 pandemic

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Journal of Integrative medicine 2023年第4期21卷 377-384页

作者： Fatma Uslu-Sahan Ilknur Yesilcınar Gonul Kurt Elif Hancer Gulten Guvenc Department of Obstetrics and Gynecologic nursing Faculty of NursingHacettepe UniversityAnkara 06100Turkey Department of Obstetrics and Gynecologic nursing Faculty of Health SciencesIzmir Katip Celebi UniversityIzmir 35620Turkey Department of Obstetrics and Gynecology nursing Gulhane Faculty of NursingUniversity of Health SciencesAnkara 06018Turkey Department of Obstetrics and Gynecology Gynecologic Oncology ClinicHacettepe University Faculty of MedicineAnkara 06800Turkey

Objective:Patients with gynecological cancer commonly use complementary and alternative medicine(CAM)methods to cope with the ***,despite the existence of treatment strategies,the effect of fear and anxiety caused by coronavirus disease 2019(COVID-19)pandemic on attitudes about CAM use is *** study was carried out to investigate the effect of fear and anxiety experienced by patients with gynecological cancer during the COVID-19 pandemic on their attitudes towards the use of ***:This is a cross-sectional and descriptive study that included 177 women with gynecological cancer;participants were recruited from a social networking site for cancer patients in Turkey between June and December *** were collected using an online survey that included the Personal Information Form,the Fear of COVID-19 Scale,the Coronavirus Anxiety Scale,and the Attitude Towards Holistic Complementary and Alternative medicine *** statistics,t-test,Pearson’s correlation test,and simple linear and multiple regression analyses were performed to analyze the ***:During the pandemic,55.4%of the participants reported using CAM methods,but only 22.6%were using CAM before the *** participants who used CAM during the pandemic also scored higher on the fear of COVID-19 and coronavirus anxiety scales(20.69±5.37 and 13.09±6.29,respectively)compared to the participants who did not use CAM(9.29±2.72 and 6.35±2.06,respectively).Fear of COVID-19 accounted for 52%of the CAM attitude score,while coronavirus anxiety accounted for 15%of the CAM attitude *** of COVID-19 and coronavirus anxiety together accounted for 53%of CAM ***:Gynecological cancer patients with high levels of COVID-19-related anxiety and fear during the pandemic used CAM *** that the psychological effects of the pandemic will continue in the coming years,CAM use should be evaluated as a coping strategy,especially due to the COVID-19-related anxiety an

关键词： Complementary and alternative medicine Anxiety COVID-19 Fear Gynecological cancer

Inhibitory activities of microalgal extracts against Epstein-Barr virus DNA release from lymphoblastoid cells

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Journal of Zhejiang university-Science B(Biomedicine & Biotechnology) 2011年第5期12卷 335-345页

作者： Yih-Yih KOK Wan-Loy CHU Siew-Moi PHANG Shar Mariam MOHAMED Rakesh NAIDU Pey-Jiun LAI Shui-Nyuk LING Joon-Wah MAK Patricia Kim-Chooi LIM Pauline BALRAJ Alan Soo-Beng KHOO Division of Human Biology International Medical University Institute of Biological sciences Faculty of Scienceand Institute of Ocean and Earth Sciences(IOES)University of Malaya faculty of medicine University of Malaya School of medicine and health sciences Monash University Molecular Pathology Unit Institute for Medical ResearchJalan Pahang

This study aimed to assess the inhibitory activities of methanol extracts from the microalgae Ankistrodesmus convolutus,Synechococcus elongatus,and Spirulina platensis against Epstein-Barr virus(EBV) in three Burkitt's lymphoma(BL) cell lines,namely Akata,B95-8,and *** antiviral activity was assessed by quantifying the cell-free EBV DNA using real-time polymerase chain reaction(PCR) *** methanol extracts from Ankistrodesmus convolutus and Synechococcus elongatus displayed low cytotoxicity and potent effect in re-ducing cell-free EBV DNA(EC5028 000).After fractionation by column chromatography,the fraction from Synechococcus elongatus(SEF1) reduced the cell-free EBV DNA most effectively(EC50=2.9 μg/ml,therapeutic index>69).Upon further fractionation by high performance liquid chromatography(HPLC),the sub-fraction SEF1'a was most active in reducing the cell-free EBV DNA(EC50=1.38 μg/ml,therapeutic index>14.5).This study suggests that microalgae could be a potential source of antiviral compounds that can be used against EBV.

关键词： Microalgae Ankistrodesmus convolutus Synechococcus elongatus Spirulina platensis Lymphoblastoid cells Epstein-Barr virus(EBV)

Comparison between Emergency Severity Index and Heart Failure Triage Scale in heart failure patients: A randomized clinical trial

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World Journal of Emergency medicine 2019年第4期10卷 215-221页

作者： Ahmad Pouyamehr Amir Mirhaghi Mohammad Davood Sharifi Ali Eshraghi nursing and Midwifery Care Research Center Mashhad University of Medical SciencesMashhadIran Department of Medical-Surgical nursing School of Nursing and MidwiferyMashhad University of Medical SciencesMashhadIran Department of Emergency medicine Faculty of MedicineMashhad University of Medical SciencesMashhadIran Department of Cardiology Faculty of MedicineMashhad University of Medical SciencesMashhadIran

BACKGROUND:It is not clear whether Emergency Severity Index(ESI)is valid to triage heart failure(HF)patients and if HF patients benefi t more from a customized triage scale or *** aim of study is to compare the effect of Heart Failure Triage Scale(HFTS)and ESI on mistriage among patients with HF who present to the emergency department(ED).METHODS:A randomized clinical trial was conducted from April to June *** patients with dyspnea were randomly assigned to HFTS or ESI *** level,used resources and time to electrocardiogram(ECG)were compared between both groups among HF patients who were admitted to coronary care unit(CCU),cardiac unit(CU)and discharged patients from the *** validity was examined using Kappa designating agreement on relevance(K*).Reliability of both scale was evaluated using inter-observer agreement(Kappa).RESULTS:Seventy-three and 74 HF patients were assigned to HFTS and ESI groups *** to ECG in HFTS group was signifi cantly shorter than that of ESI group(2.05 vs.16.82 minutes).Triage level between HFTS and ESI groups was signifi cantly different among patients admitted to CCU(1.0 vs.2.8),cardiac unit(2.26 vs.3.06)and discharged patients from the ED(3.53 vs.2.86).Used resources in HFTS group was significantly different among triage levels(H=25.89;df=3;P<0.001).CONCLUSION:HFTS is associated with less mistriage than ESI for triaging HF *** is recommended to make use of HFTS to triage HF patients in the ED.

关键词： Dyspnea Heart failure Triage Emergency severity index

Psychological impact of cancer scale:Turkish validity and reliability study

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World Journal of Psychiatry 2023年第6期13卷 351-360页

作者： Gülcan Bahçecioğlu Turan Seda Karaman Meyreme Aksoy Department of nursing Faculty of Health SciencesFırat UniversityElazığ23100Turkey faculty of nursing Atatürk UniversityErzurum 25240Turkey Department of nursing Faculty of Health SciencesSiirt UniversitySiirt 56500Turkey

BACKGROUND In the diagnosis and treatment of cancer,it is important to evaluate the components of psychological *** the key role of nurses in providing care to patients,it is important to evaluate patients,to determine highrisk patients and to use tools with acceptable validity and reliability to develop care *** To analyze the Turkish validity and reliability of The Psychological Impact of Cancer Scale(PICS).METHODS This methodological study was conducted with 257 cancer patients admitted to the oncology-haematology clinic and outpatient clinic of a university Hospital between February and October *** the translation process of the scale,content and construct validity were *** factor analysis(EFA)and confirmatory factor analysis(CFA)was examined with construct validity,while item analyses and internal consistency analysis were conducted for *** Analyses and assessment results showed that the content validity index of the scale was *** the exploratory factor analysis of the Turkish adaptation study,total variance rate explained was found as 84.98%.Factor loads of all items were between 0.82 and *** was found that Cronbach Alpha values were between 0.860 and 0.930 and total scale Cronbach Alpha value was *** and CFA showed that Turkish form of 12-item and *** Psychological Impact of Cancer Scale was confirmed with no changes to the original *** revealed good fit *** Turkish PICS is a valid and reliable measurement tool for the evaluation of individual’s psychological response to cancer diagnosis and treatment and for being used in clinical practice.

关键词： Cancer Patient Psychological impact Reliability Validity