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Long term outcomes for patients treated with half-fluence photodynamic therapy for chronic central serous chorioretinopathy: a case series

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International Journal of Ophthalmology(English edition) 2018年第2期11卷 333-336页

作者： Jennifer Doyle Bhaskar Gupta Irfan Tahir Department of Ophthalmology Royal Berkshire NHS Foundation Trust Royal Berkshire Hospital

A case series was used to evaluate the efficacy of halffluence photodynamic therapy（PDT） for chronic central serous chorioretinopathy（CSCR）. Patients were treated with standard-dose verteporfin and half-fluence PDT. Totally 13 eyes from 11 patients were included. The mean patient age was 52.0 y. There was a mean reduction in central retinal thickness of 107.0 microns. Totally 7/13 eyes（53.8%） achieved resolution of subretinal fluid（SRF） on optical coherence tomography（OCT） scan after 1 treatment with PDT. Four eyes had further treatment with PDT; of these 1 eye achieved resolution of SRF. Seven of the 13 eyes（53.8%） achieved an improvement of more than 5 ETDRS letters. One patient experienced acute macula oedema 1 d post PDT treatment. These results support the hypothesis that half-fluence PDT can have a positive effect in chronic CSCR for a gain in visual acuity and reduction in sub-retinal fluid. Acute macula oedema is a rare but potential adverse effect of half-fluence PDT.

关键词： central serous chorioretinopathy photodynamic therapy fluence

Novel microsatellite markers suggest the mechanism of parthenogenesis in Extatosoma tiaratum is automixis with terminal fusion

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Insect Science 2018年第1期25卷 24-32页

作者： Yasaman Alavi Anthony van Rooyen Mark Adrian Elgar Theresa Melanie Jones Andrew Raymond Weeks1 School of BioSciences University of Melbourne Victoria Australia Cesar Pty Ltd 293 Royal Parade Parkville Victoria Australia

Parthenogenetic reproduction is taxonomically widespread and occurs through various cytological mechanisms, which have different impact on the genetic variation of the offspring. Extatosoma tiaratum is a facultatively parthenogenetic Australian insect （Phasmatodea）, in which females oviposit continuously throughout their adult lifespan irre- spective of mating. Fertilized eggs produce sons and daughters through sexual reproduction and unfertilized eggs produce female offspring via parthenogenesis. Here, we developed novel microsatellite markers for E. tiaratum and characterized them by genotyping indi- viduals from a natural population. We then used the microsatellite markers to infer the cytological mechanism of parthenogenesis in this species. We found evidence suggesting parthenogenesis in E. tiaratum occurs through automixis with terminal fusion, resulting in substantial loss of microsatellite heterozygosity in the offspring. Loss of microsatel- lite heterozygosity may be associated with loss of heterozygosity in fitness related loci. The mechanism of parthenogenetic reproduction can therefore affect fitness outcomes and needs to be considered when comparing costs and benefits of sex versus parthenogenesis.

关键词： apomixis automixis Extatosoma tiaratum heterozygosity microsatellite markers parthenogenesis

Metabolic-associated fatty liver disease and sarcopenia:A double whammy

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World Journal of Hepatology 2024年第2期16卷 152-163页

作者： Aditya Viswanath Sherouk Fouda Cornelius James Fernandez Joseph M Pappachan School of Medicine Leicester UniversityLeicester LE17RHUnited Kingdom School of Health and Biomedical Sciences Rmit UniversityMelbourne VICAustralia Department of Endocrinology and Metabolism Pilgrim HospitalUnited Lincolnshire Hospitals NHS TrustBoston PE219QSUnited Kingdom Department of Endocrinology and Metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom Faculty of Biology Medicine and HealthThe University of ManchesterManchester M139PLUnited Kingdom

The prevalence of metabolic-associated fatty liver disease(MAFLD)has increased substantially in recent years because of the global obesity ***,now recognized as the number one cause of chronic liver disease in the world,not only increases liver-related morbidity and mortality among sufferers but also worsens the complications associated with other comorbid conditions such as cardiovascular disease,type 2 diabetes mellitus,obstructive sleep apnoea,lipid disorders and *** the interplay between MAFLD and these comorbidities is important to design optimal therapeutic *** can be either part of the disease process that results in MAFLD(e.g.,obesity or adiposity)or a consequence of MAFLD,especially in the advanced stages such as fibrosis and *** can also worsen MAFLD by reducing exercise capacity and by the production of various muscle-related chemical ***,it is crucial to thoroughly understand how we deal with these diseases,especially when they *** explore the pathobiological interlinks between MAFLD and sarcopenia in this comprehensive clinical update review article and propose evidence-based therapeutic strategies to enhance patient care.

关键词： Metabolic-associated fatty liver disease Sarcopenia Sarcopenic obesity Lean metabolic-associated fatty liver disease Cardiovascular disease Liver-muscle axis

Proximal gastric motility in critically ill patients with type 2 diabetes mellitus

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World Journal of Gastroenterology 2007年第2期13卷 270-275页

作者： Nam Q Nguyen Robert J Fraser Laura K Bryant Marianne Chapman Richard H Holloway Department of Gastroenterology Hepatology and General Medicine Royal Adelaide Hospital South Australia Investigation and Procedures Unit Repatriation General Hospital South Australia Anaesthesia and Intensive Care Royal Adelaide Hospital South Australia

AIM： To investigate the proximal gastric motor response to duodenal nutrients in critically ill patients with longstanding type 2 diabetes ***： Proximal gastric motility was assessed （using a barostat） in 10 critically ill patients with type 2 diabetes mellitus （59±3 years） during two 60-min duodenal infusions of Ensure （1 and 2 kcal/min）, in random order, separated by 2h fasting. Data were compared with 15 non-diabetic critically ill patients （48 ± 5 years） and 10 healthy volunteers （28 ±3 years）. RESULTS： Baseline proximal gastric volumes were similar between the three groups. In diabetic patients, proximal gastric relaxation during I kcal/min nutrient infusion was similar to non-diabetic patients and healthy controls. In contrast, relaxation during 2 kcal/ min infusion was initially reduced in diabetic patients （P 〈 0.05） but increased to a level similar to healthy humans, unlike non-diabetic patients where relaxation was impaired throughout the infusion. Duodenal nutrient stimulation reduced the fundic wave frequency in a dose-dependent fashion in both the critically ill diabetic patients and healthy subjects, but not in critically ill patients without diabetes. Fundic wave frequency in diabetic patients and healthy subjects was greater than in non-diabetic ***： In patients with diabetes mellitus, proximal gastric motility is less disturbed than nondiabetic patients during critical illness, suggesting that these patients may not be at greater risk of delayed gastric emptying.

关键词： Proximal gastric function Diabetes mellitus type 2 Critical illness Enteral nutrition

Important Newborn Cardiac Diagnostic Dilemmas for the Neonatologist and Cardiologist-A Clinical Perspective

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Congenital Heart Disease 2021年第2期16卷 189-196页

作者： Samuel Menahem Arvind Sehgal Department of Paediatrics University of MelbourneMelbourneAustralia School of Clinical Sciences Monash UniversityMelbourneAustralia Monash Newborn Cardiovascular ResearchMonash Children’s HospitalMelbourneAustralia Department of Paediatrics Monash UniversityMelbourneAustralia

Most congenital heart disease(CHD)is readily recognisable in the *** by previous fetal scanning,the presence of a murmur,tachypnoea,cyanosis and/or differential pulses and saturations all point to a cardiac *** serious heart disease may be missed on a fetal *** may be no murmur or clinical cyanosis,and tachypneoa may be attributed to non-cardiac *** on day 1 is usually non-cardiac except arising from ventricular failure or a large systemic arteriovenous fistula.A patent ductus arteriosus(PDA)may support either pulmonary or systemic duct dependent *** initially high pulmonary vascular resistance(PVR)limits shunts so that murmurs even from large communications between the systemic and pulmonary circulations take days/weeks to *** times despite expert input,serious CHD maybe difficult to diagnose and warrants close interaction between the neonatologist and cardiologist to reach a timely *** conditions include obstructed total anomalous pulmonary venous connections(TAPVC)and the need to distinguish it from persistent pulmonary hypertension in the newborn(PPHN)–the treatment of the former is surgical the latter medical.A large duct shunting right to left may overshadow a suspected hypoplastic aortic isthmus and/or *** the right to left shunting because of severe aortic obstruction or resulting from a high PVR with little *** diagnosis of pulmonary vein stenosis(PVS)remains problematic often developing in premature infants with ongoing bronchopulmonary dysplasia(BPD),still being cared for by the *** there are other diagnostic dilemmas including deciding the contribution of a recognised CHD in a sick neonate,this paper will focus on the above-mentioned conditions with suggestions on what may be done to arrive at a timely diagnosis to achieve optimal outcomes.

关键词： Obstructed pulmonary veins persistent pulmonary hypertension aortic coarctation pulmonary vein stenosis newborn

将WHO《心理健康差距干预指南》应用于中国全科医学服务:一项德尔菲研究

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中国全科医学 2024年第1期27卷 15-26页

作者： Kendall Searle Grant Blashki Ritsuko Kakuma 杨辉吕淑荣李宝琪肖莹莹 Harry Minas VIC 3010 Global and Cultural Mental Health Unit Centre for Mental HealthSchool of Population and Global HealthUniversity of MelbourneParkvilleAustralia VIC 3010 Nossal Institute for Global Health University of MelbourneMelbourneAustralia WC1E 7HTE London School of Hygiene and Tropical Medicine LondonEnglandUK VIC 3168 Monash Institute for Health and Clinical Education School of Primary Health CareMonash UniversityNotting HillAustralia 中国科学院大学深圳医院(光明) 广东省深圳市518107

背景中国全科医生越来越期望能够识别和预防抑郁障碍,但其接受的心理健康培训有限,社区卫生服务中心(CHCs)也缺乏针对抑郁障碍的诊断和服务规范。WHO《心理健康差距干预指南》第2版(mhGAP-IG.v2)是为非心理健康专业人员提供的决策支持工... 详细信息

背景中国全科医生越来越期望能够识别和预防抑郁障碍,但其接受的心理健康培训有限,社区卫生服务中心(CHCs)也缺乏针对抑郁障碍的诊断和服务规范。WHO《心理健康差距干预指南》第2版(mhGAP-IG.v2)是为非心理健康专业人员提供的决策支持工具,可用于评估、管理、随访精神障碍、神经疾病及物质使用障碍患者。鉴于mhGAP-IG.v2的通用性,其在中国的应用应根据抑郁障碍在不同文化下的差异性和中国心理健康系统特点进行调整。方法开展两轮基于网络的德尔菲(Delphi)调查。邀请来自深圳市的全科医生小组对mhGAP-IG.v2中涉及抑郁障碍的199条表述进行五分制的赞同程度打分,即“如要把该表述用在深圳市,是否赞同调整其内容和结构”。如果>80%的全科医生“有些/肯定赞同”调整某表述,则视为全科医生对调整该表述达成共识;如果>80%的全科医生“有些/肯定不赞同”调整某表述,则视为全科医生对不调整该表述达成共识。结果全科医生对79%的表述达成了需要调整的共识,平均得分为4.26分,即全科医生“有些赞同”对mh GAP-IG.v2中涉及抑郁障碍的相关表述进行调整。具体调整建议包括:抑郁评估方法应考虑更广泛的抑郁症状,并考虑病情的发展阶段;增加抑郁筛查工具的使用指南;明确全科医生的作用,以及家庭参与和跨部门服务的转诊途径;药物治疗建议应与中国用药规范保持一致;指南所有章节要强调预防自杀;情境化健康教育;强调“以人为本”的服务方法。全科医生认为,应维持mhGAP-IG.v2中对经历抑郁发作的双相障碍患者的诊断和治疗建议。结论对mhGAP-IG.v2抑郁部分的调整研究反映出对指南的评估应考虑文化和国情背景,包括中国特色的初级卫生保健系统、健康优先领域、治疗可得性,以及多样化的社会心理教育需要。调整后的mhGAP-IG.v2可以给中国全科医学教育和全科医疗服务提供参考,也可以为其他国家的非精神病学专业人员开展心理健康服务提供有益借鉴。

关键词：抑郁障碍心理健康差距干预指南德尔菲调整概念化初级保健跨部门服务世界卫生组织中国深圳

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Early serious adverse event in immediate postoperative period in children underwent cardiac surgery

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中国循环杂志 2018年第S1期33卷 152-153页

作者： Shengli Li A-RWICK Butt National Center for Cardiovascular Diseases Fuwai HospitalChinese Academy of Medical SciencesPeking Union Medical CollegeBeijingChina royal Children's hospital MelbourneAustralia

Objective Despite dramatic advances in surgical technique and perioperative care,some children still suffered serious adverse event in early postoperative period which were associated with increased morbidity and *** was little information regarding the impact of adverse events on the postoperative recovery,especially the serious adverse events occurring immediately after *** sought to evaluate the early postoperative serious adverse events and examine the impact of them on postoperative recovery.

关键词： Early serious adverse event children underwent cardiac surgery

Effective thermal conductivity of an intact heterogeneous limestone

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Journal of Rock Mechanics and Geotechnical Engineering 2020年第4期12卷 682-692页

作者： A.P.S.Selvadurai S.M.Rezaei Niya Department of Civil Engineering and Applied Mechanics McGill UniversityMontrealQCH3A 0C3Canada royal melbourne Institute of Technology MelbourneAustralia

The Cobourg limestone is a very low porosity rock consisting of lighter nodular regions that are predominantly calcite and darker regions consisting of calcite,quartz,dolomite,and an appreciable clay *** paper presents the application of the theory of multi-phasic composites to estimate the possible maximum effective thermal conductivity of the heterogeneous *** thermal conductivity estimates are expected to be representative of the intact rock,without fractures or fissures that can influence the heat conduction *** estimates are therefore indicative of the thermal properties of the rock in undisturbed regions unaffected by the influences of stress relief and excavation damage during construction of deep ground repositories for the disposal of heat-emitting nuclear waste.

关键词： Thermal conductivity Cobourg limestone Multi-phasic approach Voigt,Reuss and Hill estimates Hashin and Shtrikman bounds Computational modeling

Sympathetic stimulation with norepinephrine may come at a cost

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Neural Regeneration Research 2019年第6期14卷 977-978页

作者： Lakshini Y.Herat Markus P.Schlaich Vance B.Matthews Dobney Hypertension Centre School of Biomedical Science-Royal Perth Hospital UnitUniversity of Western Australia Dobney Hypertension Centre School of Medicine - Royal Perth Hospital UnitUniversity of Western Australia Department of Cardiology and Department of Nephrology Royal Perth Hospital

Norepinephrine(NE;also known as noradrenaline)is the body’s primary adrenergic neurotransmitter which belongs to the catecholamine *** has pharmacologic effects on theα1(Suita et al.,2015),α2(Schwartz,1997),β1,β2 andβ3(Tsukada et al.,2003)*** the brain,norepinephrine increases arousal and alertness,promotes vigilance,enhances formation and retrieval of memory,and focuses *** also increases restlessness and *** the remainder of the body,norepinephrine increases heart rate and blood pressure,triggers the release of glucose from energy stores,increases blood flow to skeletal muscle and increases muscle contraction,reduces blood flow to the gastrointestinal system and its motility and lastly,inhibits voiding of the bladder(Goldstein,2010).This last point is particularly interesting in the context of this perspective piece.

关键词： neurotransmitter norepinephrine increases focuses attention