Since the concept of enhanced recovery after surgery(ERAS)was introduced in the late 1990 s the idea of implementing specific interventions throughout the perioperative period to improve patient recovery has been prov...Since the concept of enhanced recovery after surgery(ERAS)was introduced in the late 1990 s the idea of implementing specific interventions throughout the perioperative period to improve patient recovery has been proven to be beneficial. Minimally invasive surgery is an integral component to ERAS and has dramatically improved post-operative outcomes. ERAS can be applicable to all surgical specialties with the core generic principles used together with added specialty specific interventions to allow for a comprehensive protocol,leading to improved clinical outcomes. Diffusion of ERAS into mainstream practice has been hindered due to minimal evidence to support individual facets and lack of method for monitoring and encouraging compliance. No single outcome measure fully captures recovery after surgery,rather multiple measures are necessary at each stage. More recently the pre-operative period has been the target of a number of strategies to improve clinical outcomes,described as prehabilitation. Innovation of technology in the surgical setting is also providing opportunities to overcome the challenges within ERAS,e.g.,the use of wearable activity monitors to record information and provide feedback and motivation to patients peri-operatively. Both modernising ERAS and providing evidence for key strategies across specialties will ultimately lead to better,more reliable patient outcomes.展开更多
Bioaerosols consist of aerosols originated biologically such as metabolites, toxins, or fragments of microorganisms that are present ubiquitously in the environment. International interests in bioaerosols have increas...Bioaerosols consist of aerosols originated biologically such as metabolites, toxins, or fragments of microorganisms that are present ubiquitously in the environment. International interests in bioaerosols have increased rapidly to broaden the pool of knowledge on their identification,quantification, distribution, and health impacts（e.g., infectious and respiratory diseases,allergies, and cancer）. However, risk assessment of bioaerosols based on conventional culture methods has been hampered further by several factors such as：（1） the complexity of microorganisms or derivatives to be investigated;（2） the purpose, techniques, and locations of sampling; and（3） the lack of valid quantitative criteria（e.g., exposure standards and dose/effect relationships）. Although exposure to some microbes is considered to be beneficial for health,more research is needed to properly assess their potential health hazards including inter-individual susceptibility, interactions with non-biological agents, and many proven/unproven health effects（e.g., atopy and atopic diseases）.展开更多
AIM: To review the currently available literature comparing laparoscopic to open resection of hepatocellular carcinoma (HCC) in patients with known liver cirrhosis.
AIM: To investigate the prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. METHODS: The demographic and histopathological data ...AIM: To investigate the prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. METHODS: The demographic and histopathological data of 1621 patients (≥ 16 years-old) who underwent appendectomy to treat an initial diagnosis of acute appendicitis between January 1999 and November 2011 were retrospectively assessed. Microscopic findings were used to classify the patients under six categories: appendix vermiformis, phlegmonous appendicitis, gan- grenous appendicitis, perforated appendicitis, supurative appendicitis, and unusual histopathologic findings. The demographic and clinicopathologic characteristics of patients with unusual histopathologic findings were evaluated in detail, and re-analysis of archived resected appendix specimens was carried out. RESULTS: A total of 912 males and 709 females, from16 to 94 years old, were included in the study and comprised 789 cases of suppurative appendicitis, 370 cases of appendix vermiformis, 243 cases of perforated gangrenous appendicitis, 53 cases of flegmaneous appendicitis, 32 cases of gangrenous appendicitis, and 134 (8.3%) cases of unusual histopathological findings. The unusual histopathological findings included fibrous obliteration (n = 62), enterobius vermicularis (n = 31), eosinophilic infiltration (n = 10), mucinous cystadenoma (n = 8), carcinoid tumor (n = 6), granulomatous inflammation (n = 5), adenocarcinoma (n = 4; one of them mucinous), and mucocele (n = 3), adenomatous polyp (n = 1), taenia sup (n = 1), ascaris lumbricoides (n = 1), appendiceal diverticula (n = 1), and B cell non-hodgkin lymphoma (n = 1). None of the 11 patients with subsequent diagnosis of tumor were suspected of cancer prior to the appendectomy. CONCLUSION: Even when the macroscopic appearance of appendectomy specimens is normal, histopathological assessment will allow early diagnosis of many unusual diseases.展开更多
BACKGROUND In recent decades, neoadjuvant therapy(NT) has been the standardized treatment for locally advanced rectal cancer(LARC). Approximately 8%-35% of patients with LARC who received NT were reported to have achi...BACKGROUND In recent decades, neoadjuvant therapy(NT) has been the standardized treatment for locally advanced rectal cancer(LARC). Approximately 8%-35% of patients with LARC who received NT were reported to have achieved a complete pathological response(pCR). If the pathological response(PR) can be accurately predicted, these patients may not need surgery. In addition, no response after NT implies that the tumor is destructive, resistant to both chemotherapy and radiotherapy, and prone to having a high metastatic potential. Therefore,developing accurate models to predict PR has great clinical significance and can help achieve individualized treatment in LARC patients.AIM To establish nomograms for predicting PR to different NT regimens based on pretreatment parameters for patients with LARC.METHODS Rectal cancer patients were identified from the database of The Sixth Affiliated Hospital, Sun Yat-sen University from January 2012 to December 2016. Logistic regression and nomograms were developed to predict the probability of pCR and good downstaging to ypT0-2N0M0(ypTNM 0-I), respectively, based on pretreatment parameters for all LARC patients. Nomograms were also developed for three NT regimens(capecitabine/deGramont-RT, mFOLFOX6, and m FOLFOX6-RT) to predict pCR probability.RESULTS Four hundred and three patients were included in this study; 72(17.9%) had pCR at the final pathology report, and 177(43.9%) achieved good downstaging to ypT0-2N0M0(ypTNM 0-I). The nomogram for predicting pCR probability showed that NT regimens, tumor differentiation, mesorectal fascia(MRF) status,and tumor length significantly influenced pCR probability. When predicting the probability of good downstaging, tumor differentiation, MRF status, and clinical T stage were the significant factors. Nomograms were developed based on NT regimens. For the capecitabine/de Gramont-RT group, the multivariate analysis showed that the neutrophil-lymphocyte ratio(NLR) was the only significant factor, thus we could not develop a nomogram for this regim展开更多
Vernacular buildings across the globe provide instructive examples of sustainable solutions to building problems. Yet, these solutions are assumed to be inapplicable to modern buildings. Despite some views to the cont...Vernacular buildings across the globe provide instructive examples of sustainable solutions to building problems. Yet, these solutions are assumed to be inapplicable to modern buildings. Despite some views to the contrary, there continues to be a tendency to consider innovative building technology as the hallmark of modern architecture because tradition is commonly viewed as the antonym of modernity. The problem is addressed by practical exercises and fieldwork studies in the application of vernacular traditions to current problems. This study investigates some aspects of mainstream modernist design solutions and concepts inherent in the vernacular of Asia, particularly that of the Chittagong Hill Tracts （CHT）. This work hinges on such ideas and practices as ecological design, modular and incremental design, standardization, and flexible and temporal concepts in the design of spaces. The blurred edges between the traditional and modern technical aspects of building design, as addressed by both vernacular builders and modern architects, are explored.展开更多
This study aimed to explore the barriers affecting COVID-19 vaccine uptake among ethnic minorities and to propose strategies to strengthen government initiatives for inclusive vaccination. Grounded in social construct...This study aimed to explore the barriers affecting COVID-19 vaccine uptake among ethnic minorities and to propose strategies to strengthen government initiatives for inclusive vaccination. Grounded in social constructivism, this qualitative study was conducted in the greater Sylhet Division, where many ethnic communities live. Using purposive sampling, semi-structured interviews were conducted with 49 participants, including ethnic men and women, community leaders, and healthcare providers. Two focus group discussions (FGDs) were also conducted to ensure data validation, and the results were analyzed using thematic analysis, which revealed several factors, such as free vaccinations, media, close community-knit healthcare centers, informal communication that positively influenced vaccine uptake, such as awareness campaigns, informal communication, media involvement, and free vaccine availability. However, socio-economic and technological barriers pose significant challenges, including misconceptions about vaccines, limited access to technology, long distances to vaccination centers, inconvenient service hours, and reliance on traditional medicine. To promote inclusive vaccination, the study recommends establishing localized vaccine camps, improving technological infrastructure such as the Internet and network access, enhancing communication strategies, providing special services for women, the elderly and disabled individuals, and ensuring a reliable vaccine supply. Future researchers could apply longitudinal studies, including a lager study area and broader range of participants to address the missing perspectives in the current study.展开更多
Water quality is the critical environmental determinant that influences the agricultural production and therefore, the economy that solely depends on its agricultural productions. Batiaghata Upazilla is one of the maj...Water quality is the critical environmental determinant that influences the agricultural production and therefore, the economy that solely depends on its agricultural productions. Batiaghata Upazilla is one of the major crop productive areas of Khulna region and the agricultural production here largely depends on the natural water of the Shailmari River system around it. The present study was conducted to assess the suitability of this coastal river water for irrigational use. 66 water samples were collected during this study in three consecutive agricultural seasons, viz., pre-monsoon (22), monsoon (22) and post-monsoon (22) from 11 sampling stations within the river system considering the high (11) and ebb (11) tides for each station. Standard methods were followed throughout the study period for the collection of the samples and analysis of major physicochemical parameters (pH, EC, TDS, salinity, Na, K, Ca, Mg, Cl, HCO<sub>3</sub>, SO<sub>4</sub>, NO<sub>3</sub> and PO<sub>4</sub>). Hydrocehmical characterization using Piper trilinear diagram shows that the water of the river system is Na-Cl dominated saline water type in pre-monsoon, whilst most of the samples of the river and the connected channel are characterized as fresh water of Ca-Mg-Na-HCO<sub>3</sub> and Ca-Na-Mg-HCO<sub>3</sub> types in monsoon and post-monsoon respectively. The calculated values of chemical indices like SAR, %Na, KI, PI and MH using the results of the analysed parameters indicate that the river water is chemically unsuitable for use in irrigation during pre-monsoon, while in the monsoon and post-monsoon the river water is within good to permissible limit for the use in the agricultural fields. However, high %Na, KI and MH values with high salinity of the channel water limit its use in agricultural applications in monsoon and post-monsoon. The USSL (United States Salinity Laboratory) diagram depicts that the river water is C4-S4 type with very high salinity and sodium content in pre-monsoon, while in other seasons the water is mostly展开更多
Research Background: Cervical cancer is the second most common cancer in women and the third leading cause of female cancer death in Bangladesh. Delay in initiation of treatment in advanced stage cervical cancer patie...Research Background: Cervical cancer is the second most common cancer in women and the third leading cause of female cancer death in Bangladesh. Delay in initiation of treatment in advanced stage cervical cancer patients is an important modifiable risk factor for cancer-related mortality. Identifying elements associated with delay of diagnosis will help reduce barriers to timely treatment of cervical cancer. Research Objectives: The objective of this study was to analyze the factors leading to delay in diagnosis and treatment of women with advanced stage cervical cancer. Methods: A cross-sectional observational study analyzed the factors associated with delay in initiation of treatment for 138 patients with advanced-stage cervical cancer from November 2019 to October 2020 at the National Institute of Cancer Research and Hospital (NICRH) in Dhaka, Bangladesh. Advanced-stage cervical cancer patients between the ages of 30 to 70 years were included in this study. Face-to-face interviews with the participants used a predesigned data collection sheet. In this study, three components of delay were identified: primary delay due to patient factors, healthcare provider delay, and healthcare-system infrastructure delay. Factors associated with delay were the independent variables and durations of delay were the outcome variables. Descriptive statistics were expressed as mean + standard deviation, median, percentage, and frequency. Results: One hundred and thirty-eight patients with advanced stage cervical cancer were included in the study. The mean age of the patients was 48.74 (±9.57) years. Thirty-four percent of patients were illiterate. More than half (57.25%) of the patients were from lower middle-class families. Delays were categorized as patient-related, healthcare provider delay, and healthcare-system infrastructure related. Patient-related factors included low monthly income, residence in a rural area, embarrassment, fear, lack of knowledge regarding cervical cancer, delay in contacting a spouse, family member or展开更多
The light is one of the important factors for the microalgae growth in the biofuel technology. As biofuel project is large and expensive thus before setting a microalgae based biofuel project in any geographical locat...The light is one of the important factors for the microalgae growth in the biofuel technology. As biofuel project is large and expensive thus before setting a microalgae based biofuel project in any geographical location, it is important to investigate the suitability of all important parameters involving with the system. This paper aims to investigate the sunlight availability and the microalgae growth for a photobioreactor at Chittagong University of Engineering and Technology (CUET). A computational growth model related to the average irradiance is proposed to calculate the growth of microalgae. We observed that average irradiance is the highest in June and is the lowest in December. From our simulation it is found that the growth of microalgae varies with the average irradiance in a year.展开更多
Breast cancer is a major health problem that affects more than 24% of women in Bangladesh. Furthermore, among low-income countries including Bangladesh, individuals have a high risk for developing breast cancer. This ...Breast cancer is a major health problem that affects more than 24% of women in Bangladesh. Furthermore, among low-income countries including Bangladesh, individuals have a high risk for developing breast cancer. This study aimed to identify candidate mitochondrial DNA (mtDNA) biomarkers for breast cancer diagnosis in Bangladeshi women to be used as a preventive approach. We screened the blood samples from 24 breast cancer patients and 20 healthy controls to detect polymorphisms in the D-loop and the ND3-and ND4-coding regions of mtDNA by direct sequencing. Among 14 distinct mutations, 10 polymorphisms were found in the D-loop, 3 were found in the ND3-coding region, and 1 was found in the ND4-coding region. The frequency of two novel polymorphisms in the D-loop, one at position 16290 (Tins) and the other at position 16293 (A-del), was higher in breast cancer patients than in control subjects (position 16290: odds ratio = 6.011, 95% confidence interval = 1.2482 to 28.8411, P = 0.002; position 16293: odds ratio = 5.6028, 95% confidence interval = 1.4357 to 21.8925, P = 0.010). We also observed one novel mutation in the ND3-coding region at position 10316 (A > G) in 69% of breast cancer patients but not in control subjects. The study suggests that two novel polymorphisms in the D-loop may be candidate biomarkers for breast展开更多
The growth factor midkine （MK） is a cytokine that inhibits HIV infection in cell cultures in an autocrine and paracrine manner by blocking the attachment of HIV particles to permissive cells. MK mRNA is systematical...The growth factor midkine （MK） is a cytokine that inhibits HIV infection in cell cultures in an autocrine and paracrine manner by blocking the attachment of HIV particles to permissive cells. MK mRNA is systematically expressed in adult peripheral blood lymphocytes from healthy donors, while its expression becomes markedly but transiently increased upon in vitro treatment of lymphocytes with IL-2 or IFN-7 and activation of T lymphocytes by PHA or through the engagement of the CD28 antigen. The binding of MK to cells occurs specifically at a high and a low affinity binding site. This low affinity-binding site is the cell-surface expressed nucleolin, which is implicated in the mechanism of the initial attachment of HIV particles to cells. Accordingly, the nucleolin-binding HB-19 pseudopeptide has no effect on the MK binding to the high affinity binding site, whereas it prevents the binding of MK to the low affinity binding site, thus suggesting the low affinity receptor of MK is the cell-surface-expressed nucleolin. Confocal immunofluorescence laser microscopy revealed the colocalization of MK and the cell-surface-expressed nucleolin at distinct spots. The use of various deletion constructs of nucleolin then indicates that the extreme C-terminal end of nucleolin, containing repeats of the amino acid motif RGG, as the domain that binds MK. The specific binding of MK to the surface nucleolin is independent of heparan sulfate and chondroitin sulfate proteoglycans. After binding to cells, MK enters cells by an active process in which nucleolin and lipid rafts appear to be implicated. The potent and the distinct anti-HIV action of MK along with its enhanced expression in lymphocytes by various physiological stimuli, point out that MK is a cytokine that could be involved in HIV pathogenesis.展开更多
The Circular Electron Positron Collider(CEPC)is a large scientific project initiated and hosted by China,fostered through extensive collaboration with international partners.The complex comprises four accelerators:a 3...The Circular Electron Positron Collider(CEPC)is a large scientific project initiated and hosted by China,fostered through extensive collaboration with international partners.The complex comprises four accelerators:a 30 GeV Linac,a 1.1 GeV Damping Ring,a Booster capable of achieving energies up to 180 GeV,and a Collider operating at varying energy modes(Z,W,H,and tt).The Linac and Damping Ring are situated on the surface,while the subterranean Booster and Collider are housed in a 100 km circumference underground tunnel,strategically accommodating future expansion with provisions for a potential Super Proton Proton Collider(SPPC).The CEPC primarily serves as a Higgs factory.In its baseline design with synchrotron radiation(SR)power of 30 MW per beam,it can achieve a luminosity of 5×10^(34)cm^(-2)s^(-1)per interaction point(IP),resulting in an integrated luminosity of 13 ab^(-1)for two IPs over a decade,producing 2.6 million Higgs bosons.Increasing the SR power to 50 MW per beam expands the CEPC's capability to generate 4.3 million Higgs bosons,facilitating precise measurements of Higgs coupling at sub-percent levels,exceeding the precision expected from the HL-LHC by an order of magnitude.This Technical Design Report(TDR)follows the Preliminary Conceptual Design Report(Pre-CDR,2015)and the Conceptual Design Report(CDR,2018),comprehensively detailing the machine's layout,performance metrics,physical design and analysis,technical systems design,R&D and prototyping efforts,and associated civil engineering aspects.Additionally,it includes a cost estimate and a preliminary construction timeline,establishing a framework for forthcoming engineering design phase and site selection procedures.Construction is anticipated to begin around 2027-2028,pending government approval,with an estimated duration of 8 years.The commencement of experiments and data collection could potentially be initiated in the mid-2030s.展开更多
Objective: Increasing the emergence of Metallo-β-lactamase (MBL) producing gram-negative bacteria and their dexterous horizontal transmission demands rapid and accurate detection. This study was conducted to determin...Objective: Increasing the emergence of Metallo-β-lactamase (MBL) producing gram-negative bacteria and their dexterous horizontal transmission demands rapid and accurate detection. This study was conducted to determine a suitable method to promptly detect MBL-producing gram-negative bacteria. Methods: A total of 103 gram-negative bacteria were identified from various clinical samples at a tertiary care hospital in Dhaka city. MBL producers were detected by two phenotypic methods, the Disk Potentiation Test (DPT) and the Double Disk Synergy Test (DDST) based on β-lactam chelator combinations where EDTA/SMA has been used as an inhibitor and Imipenem, Ceftazidime as substrates. Results: 103 isolates which were identified as Escherichia coli spp, Klebsiella spp, Pseudomonas spp, Acinetobacter spp, Proteus spp, Providencia spp were found to be multidrug-resistant in antibiogram test. Isolates showed complete resistance (100%) to Imipenem, Meropenem, and Amoxiclav. The highest carbapenem-resistant etiological agents were Acinetobacter spp 40 (38.8%) followed by Pseudomonas spp 27 (26.2%), Klebsiella spp 26 (25.2%), Escherichia coli 8 (7.8%), Proteus spp 1 (1%) and Providencia spp 1 (1%). DPT method detected significantly (p = 0.000009) a higher number of MBL-producers (Imipenem with 0.5 M EDTA n = 61, 59.2% & Ceftazidime with 0.5 M EDTA n = 56, 54.4%) compared to the DDST method (Imipenem -0.5 M EDTA n = 43, 41.7%, Imipenem – SMA n = 38, 36.9% & Ceftazidime -0.5 M EDTA n = 15, 14.6%). Conclusion: Pieces of evidence suggest that DPT is a more sensitive method than DDST and could be recommended for identifying MBL-producing bacteria in Bangladeshi hospitals for the proper management of patients, to reduce time constraints and treatment costs.展开更多
The Jiangmen Underground Neutrino Observatory(JUNO)is a large liquid scintillator detector designed to explore many topics in fundamental physics.In this study,the potential of searching for proton decay in the p→νK...The Jiangmen Underground Neutrino Observatory(JUNO)is a large liquid scintillator detector designed to explore many topics in fundamental physics.In this study,the potential of searching for proton decay in the p→νK^(+)mode with JUNO is investigated.The kaon and its decay particles feature a clear three-fold coincidence signature that results in a high efficiency for identification.Moreover,the excellent energy resolution of JUNO permits suppression of the sizable background caused by other delayed signals.Based on these advantages,the detection efficiency for the proton decay via p→νK^(+)is 36.9%±4.9%with a background level of 0.2±0.05(syst)±0.2(stat)events after 10 years of data collection.The estimated sensitivity based on 200 kton-years of exposure is 9.6×1033 years,which is competitive with the current best limits on the proton lifetime in this channel and complements the use of different detection technologies.展开更多
Gender inclusiveness is important in the rural transformation process of Bangladesh as rural women play key roles in both agricultural and non-agricultural sectors.Gender inclusiveness also leads to gender equity.We e...Gender inclusiveness is important in the rural transformation process of Bangladesh as rural women play key roles in both agricultural and non-agricultural sectors.Gender inclusiveness also leads to gender equity.We empirically evaluate relationships between rural transformation and gender inclusiveness in Bangladesh.We consider three rural transformation indicators:high-value commodities’share in agricultural output values,non-farm employment’s share in rural labor employment,and non-agricultural GDP’s share in total GDP.Indicators capturing gender inclusiveness include the per capita rural income of males and females,ratio of investments into gender programs,female access to education,access to healthcare,employment participation,land ownership,and asset ownership.We test the effect of the difference in per capita rural income of males and females and the ratio of their incomes and check for the robustness of the gender variables across different model specifications.Analyzing 128 district-level observations from 32 districts of Bangladesh across four time periods(2000,2005,2010 and 2016),we use both ordinary least squares and fixed effects panel regression models.We find that female land and asset ownership and access to education and healthcare are robust determinants of various stages of rural transformation.Thus,our results suggest that improving women’s ownership of land and assets and investing in women’s education and healthcare will likely contribute to a more inclusive rural transformation.展开更多
Burn wounds result from exposure to hot liquids,chemicals,fire,electric discharge or radiation.Wound severity ranges from first-degree injury,which is superficial,to fourth-degree injury,which exposes bone,tendons and...Burn wounds result from exposure to hot liquids,chemicals,fire,electric discharge or radiation.Wound severity ranges from first-degree injury,which is superficial,to fourth-degree injury,which exposes bone,tendons and muscles.Rapid assessment of burn depth and accurate wound management in the outpatient setting is critical to prevent injury progression into deeper layers of the dermis.Injury progression is of particular pertinence to second-degree burns,which are the most common form of thermal burn.As our understanding of wound healing advances,treatment options and technologies for second-degree burn management also evolve.Polymeric hydrogels are a class of burn wound dressings that adhere to tissue,absorb wound exudate,protect from the environment,can be transparent facilitating serial wound evaluation and,in some cases,enable facile removal for dressing changes.This review briefly describes the burn level classification and common,commercially available dressings used to treat second-degree burns,and then focuses on new polymeric hydrogel burn dressings under preclinical development analyzing their design,structure and performance.The review presents the follow key learning points:(1)introduction to the integument system and the wound-healing process;(2)classification of burns according to severity and clinical appearance;(3)available dressings currently used for second-degree burns;(4)introduction to hydrogels and their preparation and characterization techniques;and(5)pre-clinical hydrogel burn wound dressings currently being developed.展开更多
AIM: To clarify the pathogenesis of gastroesophageal reflux disease symptoms in non-erosive reflux disease(NERD) patients.METHODS: Thirty-five NERD patients with persistent symptoms, despite taking rabeprazole 10 mg t...AIM: To clarify the pathogenesis of gastroesophageal reflux disease symptoms in non-erosive reflux disease(NERD) patients.METHODS: Thirty-five NERD patients with persistent symptoms, despite taking rabeprazole 10 mg twice daily for at least 8 wk, were included in this study. All patients underwent 24 h combined impedance- p H on rabeprazole. The symptom index(SI) was considered to be positive if ≥ 50%, and proximal reflux episodes were determined when reflux reached 15 cm above the proximal margin of the lower esophageal sphincter.RESULTS: In 14(40%) SI-positive patients, with liquid weakly acid reflux, the occurrence rate of reflux symptoms was significantly more frequent in proximal reflux episodes(46.7%) than in distal ones(5.7%)(P < 0.001). With liquid acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(38.5%) and distal ones(20.5%)(NS). With mixed liquid-gas weakly acid reflux, the occurrence rate of reflux symptoms in proximal reflux episodes was significantly more frequent(31.0%) than in distal reflux ones(3.3%)(P < 0.001). With mixed liquid-gas acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(29.4%) and distal ones(14.3%)(NS).CONCLUSION: The proximal extent of weakly acidic liquid and mixed liquid-gas reflux is a major factor associated with reflux perception in SI-positive patients on proton pump inhibitor therapy.展开更多
Purpose: This study aims to analyze the effects of a 3-month vigorous physical activity(VPA) intervention on eating behavior and body composition in overweight and obese children and adolescents.Methods: Forty-seven p...Purpose: This study aims to analyze the effects of a 3-month vigorous physical activity(VPA) intervention on eating behavior and body composition in overweight and obese children and adolescents.Methods: Forty-seven participants(7–16 years) took part in the study: 28 were assigned to the intervention group(IG)(10 boys and 18 girls) and19 in a control group(CG)(8 boys and 11 girls). Body composition(dual-energy X-ray absorptiometry), anthropometrics(body mass, height, and body mass index(BMI)), and eating behavior traits(Three-Factor Eating Questionnaire-R21 C) were determined before and after the VPA intervention.Results: A decrease in the percentage of body fat and BMI(-2.8% and-1.8%, respectively), and an increase in most lean mass variables were found in the IG(all p ≤ 0.05). In relation to the eating behavior traits, IG subjects showed a 14% reduction in the Emotional Eating score(p = 0.04),while Cognitive Restraint score did not change after the VPA intervention. The baseline factors of the questionnaire predicted changes in body mass and fat mass variables only in the CG.Conclusion: A 3-month VPA intervention influenced eating behaviors of overweight or obese young, especially the Emotional Eating factor, in the presence of favorable body composition changes.展开更多
文摘Since the concept of enhanced recovery after surgery(ERAS)was introduced in the late 1990 s the idea of implementing specific interventions throughout the perioperative period to improve patient recovery has been proven to be beneficial. Minimally invasive surgery is an integral component to ERAS and has dramatically improved post-operative outcomes. ERAS can be applicable to all surgical specialties with the core generic principles used together with added specialty specific interventions to allow for a comprehensive protocol,leading to improved clinical outcomes. Diffusion of ERAS into mainstream practice has been hindered due to minimal evidence to support individual facets and lack of method for monitoring and encouraging compliance. No single outcome measure fully captures recovery after surgery,rather multiple measures are necessary at each stage. More recently the pre-operative period has been the target of a number of strategies to improve clinical outcomes,described as prehabilitation. Innovation of technology in the surgical setting is also providing opportunities to overcome the challenges within ERAS,e.g.,the use of wearable activity monitors to record information and provide feedback and motivation to patients peri-operatively. Both modernising ERAS and providing evidence for key strategies across specialties will ultimately lead to better,more reliable patient outcomes.
基金support made in part by grants from the National Research Foundation of Korea(NRF)funded by the Ministry of Science,ICT&Future Planning(No.2016R1E1A1A01940995)
文摘Bioaerosols consist of aerosols originated biologically such as metabolites, toxins, or fragments of microorganisms that are present ubiquitously in the environment. International interests in bioaerosols have increased rapidly to broaden the pool of knowledge on their identification,quantification, distribution, and health impacts（e.g., infectious and respiratory diseases,allergies, and cancer）. However, risk assessment of bioaerosols based on conventional culture methods has been hampered further by several factors such as：（1） the complexity of microorganisms or derivatives to be investigated;（2） the purpose, techniques, and locations of sampling; and（3） the lack of valid quantitative criteria（e.g., exposure standards and dose/effect relationships）. Although exposure to some microbes is considered to be beneficial for health,more research is needed to properly assess their potential health hazards including inter-individual susceptibility, interactions with non-biological agents, and many proven/unproven health effects（e.g., atopy and atopic diseases）.
文摘AIM: To review the currently available literature comparing laparoscopic to open resection of hepatocellular carcinoma (HCC) in patients with known liver cirrhosis.
文摘AIM: To investigate the prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. METHODS: The demographic and histopathological data of 1621 patients (≥ 16 years-old) who underwent appendectomy to treat an initial diagnosis of acute appendicitis between January 1999 and November 2011 were retrospectively assessed. Microscopic findings were used to classify the patients under six categories: appendix vermiformis, phlegmonous appendicitis, gan- grenous appendicitis, perforated appendicitis, supurative appendicitis, and unusual histopathologic findings. The demographic and clinicopathologic characteristics of patients with unusual histopathologic findings were evaluated in detail, and re-analysis of archived resected appendix specimens was carried out. RESULTS: A total of 912 males and 709 females, from16 to 94 years old, were included in the study and comprised 789 cases of suppurative appendicitis, 370 cases of appendix vermiformis, 243 cases of perforated gangrenous appendicitis, 53 cases of flegmaneous appendicitis, 32 cases of gangrenous appendicitis, and 134 (8.3%) cases of unusual histopathological findings. The unusual histopathological findings included fibrous obliteration (n = 62), enterobius vermicularis (n = 31), eosinophilic infiltration (n = 10), mucinous cystadenoma (n = 8), carcinoid tumor (n = 6), granulomatous inflammation (n = 5), adenocarcinoma (n = 4; one of them mucinous), and mucocele (n = 3), adenomatous polyp (n = 1), taenia sup (n = 1), ascaris lumbricoides (n = 1), appendiceal diverticula (n = 1), and B cell non-hodgkin lymphoma (n = 1). None of the 11 patients with subsequent diagnosis of tumor were suspected of cancer prior to the appendectomy. CONCLUSION: Even when the macroscopic appearance of appendectomy specimens is normal, histopathological assessment will allow early diagnosis of many unusual diseases.
基金National Basic Research Program of China(973Program),No.2015CB554001National Natural Science Foundation of China,No.81472257 and No.81502022+7 种基金Natural Science Fund for Distinguished Young Scholars of Guangdong Province,No.2016A030306002Tip-top Scientific and Technical Innovative Youth Talents of Guangdong Special Support Program,No.2015TQ01R454Natural Science Foundation of Guangdong Province,No.2016A030310222 and No.2018A0303130303Science and Technology Program of Guangzhou,No.201506010099 and No.2014Y2-00160Science and Technology Program of Guangdong Province,No.2014A020215011Fundamental Research Funds for the Central Universities(Sun Yat-sen University),No.2015ykzd10 and No.16ykpy35Program of Introducing Talents of Discipline to UniversitiesNational Key Clinical Discipline
文摘BACKGROUND In recent decades, neoadjuvant therapy(NT) has been the standardized treatment for locally advanced rectal cancer(LARC). Approximately 8%-35% of patients with LARC who received NT were reported to have achieved a complete pathological response(pCR). If the pathological response(PR) can be accurately predicted, these patients may not need surgery. In addition, no response after NT implies that the tumor is destructive, resistant to both chemotherapy and radiotherapy, and prone to having a high metastatic potential. Therefore,developing accurate models to predict PR has great clinical significance and can help achieve individualized treatment in LARC patients.AIM To establish nomograms for predicting PR to different NT regimens based on pretreatment parameters for patients with LARC.METHODS Rectal cancer patients were identified from the database of The Sixth Affiliated Hospital, Sun Yat-sen University from January 2012 to December 2016. Logistic regression and nomograms were developed to predict the probability of pCR and good downstaging to ypT0-2N0M0(ypTNM 0-I), respectively, based on pretreatment parameters for all LARC patients. Nomograms were also developed for three NT regimens(capecitabine/deGramont-RT, mFOLFOX6, and m FOLFOX6-RT) to predict pCR probability.RESULTS Four hundred and three patients were included in this study; 72(17.9%) had pCR at the final pathology report, and 177(43.9%) achieved good downstaging to ypT0-2N0M0(ypTNM 0-I). The nomogram for predicting pCR probability showed that NT regimens, tumor differentiation, mesorectal fascia(MRF) status,and tumor length significantly influenced pCR probability. When predicting the probability of good downstaging, tumor differentiation, MRF status, and clinical T stage were the significant factors. Nomograms were developed based on NT regimens. For the capecitabine/de Gramont-RT group, the multivariate analysis showed that the neutrophil-lymphocyte ratio(NLR) was the only significant factor, thus we could not develop a nomogram for this regim
文摘Vernacular buildings across the globe provide instructive examples of sustainable solutions to building problems. Yet, these solutions are assumed to be inapplicable to modern buildings. Despite some views to the contrary, there continues to be a tendency to consider innovative building technology as the hallmark of modern architecture because tradition is commonly viewed as the antonym of modernity. The problem is addressed by practical exercises and fieldwork studies in the application of vernacular traditions to current problems. This study investigates some aspects of mainstream modernist design solutions and concepts inherent in the vernacular of Asia, particularly that of the Chittagong Hill Tracts （CHT）. This work hinges on such ideas and practices as ecological design, modular and incremental design, standardization, and flexible and temporal concepts in the design of spaces. The blurred edges between the traditional and modern technical aspects of building design, as addressed by both vernacular builders and modern architects, are explored.
文摘This study aimed to explore the barriers affecting COVID-19 vaccine uptake among ethnic minorities and to propose strategies to strengthen government initiatives for inclusive vaccination. Grounded in social constructivism, this qualitative study was conducted in the greater Sylhet Division, where many ethnic communities live. Using purposive sampling, semi-structured interviews were conducted with 49 participants, including ethnic men and women, community leaders, and healthcare providers. Two focus group discussions (FGDs) were also conducted to ensure data validation, and the results were analyzed using thematic analysis, which revealed several factors, such as free vaccinations, media, close community-knit healthcare centers, informal communication that positively influenced vaccine uptake, such as awareness campaigns, informal communication, media involvement, and free vaccine availability. However, socio-economic and technological barriers pose significant challenges, including misconceptions about vaccines, limited access to technology, long distances to vaccination centers, inconvenient service hours, and reliance on traditional medicine. To promote inclusive vaccination, the study recommends establishing localized vaccine camps, improving technological infrastructure such as the Internet and network access, enhancing communication strategies, providing special services for women, the elderly and disabled individuals, and ensuring a reliable vaccine supply. Future researchers could apply longitudinal studies, including a lager study area and broader range of participants to address the missing perspectives in the current study.
文摘Water quality is the critical environmental determinant that influences the agricultural production and therefore, the economy that solely depends on its agricultural productions. Batiaghata Upazilla is one of the major crop productive areas of Khulna region and the agricultural production here largely depends on the natural water of the Shailmari River system around it. The present study was conducted to assess the suitability of this coastal river water for irrigational use. 66 water samples were collected during this study in three consecutive agricultural seasons, viz., pre-monsoon (22), monsoon (22) and post-monsoon (22) from 11 sampling stations within the river system considering the high (11) and ebb (11) tides for each station. Standard methods were followed throughout the study period for the collection of the samples and analysis of major physicochemical parameters (pH, EC, TDS, salinity, Na, K, Ca, Mg, Cl, HCO<sub>3</sub>, SO<sub>4</sub>, NO<sub>3</sub> and PO<sub>4</sub>). Hydrocehmical characterization using Piper trilinear diagram shows that the water of the river system is Na-Cl dominated saline water type in pre-monsoon, whilst most of the samples of the river and the connected channel are characterized as fresh water of Ca-Mg-Na-HCO<sub>3</sub> and Ca-Na-Mg-HCO<sub>3</sub> types in monsoon and post-monsoon respectively. The calculated values of chemical indices like SAR, %Na, KI, PI and MH using the results of the analysed parameters indicate that the river water is chemically unsuitable for use in irrigation during pre-monsoon, while in the monsoon and post-monsoon the river water is within good to permissible limit for the use in the agricultural fields. However, high %Na, KI and MH values with high salinity of the channel water limit its use in agricultural applications in monsoon and post-monsoon. The USSL (United States Salinity Laboratory) diagram depicts that the river water is C4-S4 type with very high salinity and sodium content in pre-monsoon, while in other seasons the water is mostly
文摘Research Background: Cervical cancer is the second most common cancer in women and the third leading cause of female cancer death in Bangladesh. Delay in initiation of treatment in advanced stage cervical cancer patients is an important modifiable risk factor for cancer-related mortality. Identifying elements associated with delay of diagnosis will help reduce barriers to timely treatment of cervical cancer. Research Objectives: The objective of this study was to analyze the factors leading to delay in diagnosis and treatment of women with advanced stage cervical cancer. Methods: A cross-sectional observational study analyzed the factors associated with delay in initiation of treatment for 138 patients with advanced-stage cervical cancer from November 2019 to October 2020 at the National Institute of Cancer Research and Hospital (NICRH) in Dhaka, Bangladesh. Advanced-stage cervical cancer patients between the ages of 30 to 70 years were included in this study. Face-to-face interviews with the participants used a predesigned data collection sheet. In this study, three components of delay were identified: primary delay due to patient factors, healthcare provider delay, and healthcare-system infrastructure delay. Factors associated with delay were the independent variables and durations of delay were the outcome variables. Descriptive statistics were expressed as mean + standard deviation, median, percentage, and frequency. Results: One hundred and thirty-eight patients with advanced stage cervical cancer were included in the study. The mean age of the patients was 48.74 (±9.57) years. Thirty-four percent of patients were illiterate. More than half (57.25%) of the patients were from lower middle-class families. Delays were categorized as patient-related, healthcare provider delay, and healthcare-system infrastructure related. Patient-related factors included low monthly income, residence in a rural area, embarrassment, fear, lack of knowledge regarding cervical cancer, delay in contacting a spouse, family member or
文摘The light is one of the important factors for the microalgae growth in the biofuel technology. As biofuel project is large and expensive thus before setting a microalgae based biofuel project in any geographical location, it is important to investigate the suitability of all important parameters involving with the system. This paper aims to investigate the sunlight availability and the microalgae growth for a photobioreactor at Chittagong University of Engineering and Technology (CUET). A computational growth model related to the average irradiance is proposed to calculate the growth of microalgae. We observed that average irradiance is the highest in June and is the lowest in December. From our simulation it is found that the growth of microalgae varies with the average irradiance in a year.
基金supported by grants from the Centre for Advanced Research in Sciences(CARS),University of Dhaka
文摘Breast cancer is a major health problem that affects more than 24% of women in Bangladesh. Furthermore, among low-income countries including Bangladesh, individuals have a high risk for developing breast cancer. This study aimed to identify candidate mitochondrial DNA (mtDNA) biomarkers for breast cancer diagnosis in Bangladeshi women to be used as a preventive approach. We screened the blood samples from 24 breast cancer patients and 20 healthy controls to detect polymorphisms in the D-loop and the ND3-and ND4-coding regions of mtDNA by direct sequencing. Among 14 distinct mutations, 10 polymorphisms were found in the D-loop, 3 were found in the ND3-coding region, and 1 was found in the ND4-coding region. The frequency of two novel polymorphisms in the D-loop, one at position 16290 (Tins) and the other at position 16293 (A-del), was higher in breast cancer patients than in control subjects (position 16290: odds ratio = 6.011, 95% confidence interval = 1.2482 to 28.8411, P = 0.002; position 16293: odds ratio = 5.6028, 95% confidence interval = 1.4357 to 21.8925, P = 0.010). We also observed one novel mutation in the ND3-coding region at position 10316 (A > G) in 69% of breast cancer patients but not in control subjects. The study suggests that two novel polymorphisms in the D-loop may be candidate biomarkers for breast
文摘The growth factor midkine （MK） is a cytokine that inhibits HIV infection in cell cultures in an autocrine and paracrine manner by blocking the attachment of HIV particles to permissive cells. MK mRNA is systematically expressed in adult peripheral blood lymphocytes from healthy donors, while its expression becomes markedly but transiently increased upon in vitro treatment of lymphocytes with IL-2 or IFN-7 and activation of T lymphocytes by PHA or through the engagement of the CD28 antigen. The binding of MK to cells occurs specifically at a high and a low affinity binding site. This low affinity-binding site is the cell-surface expressed nucleolin, which is implicated in the mechanism of the initial attachment of HIV particles to cells. Accordingly, the nucleolin-binding HB-19 pseudopeptide has no effect on the MK binding to the high affinity binding site, whereas it prevents the binding of MK to the low affinity binding site, thus suggesting the low affinity receptor of MK is the cell-surface-expressed nucleolin. Confocal immunofluorescence laser microscopy revealed the colocalization of MK and the cell-surface-expressed nucleolin at distinct spots. The use of various deletion constructs of nucleolin then indicates that the extreme C-terminal end of nucleolin, containing repeats of the amino acid motif RGG, as the domain that binds MK. The specific binding of MK to the surface nucleolin is independent of heparan sulfate and chondroitin sulfate proteoglycans. After binding to cells, MK enters cells by an active process in which nucleolin and lipid rafts appear to be implicated. The potent and the distinct anti-HIV action of MK along with its enhanced expression in lymphocytes by various physiological stimuli, point out that MK is a cytokine that could be involved in HIV pathogenesis.
基金support from diverse funding sources,including the National Key Program for S&T Research and Development of the Ministry of Science and Technology(MOST),Yifang Wang's Science Studio of the Ten Thousand Talents Project,the CAS Key Foreign Cooperation Grant,the National Natural Science Foundation of China(NSFC)Beijing Municipal Science&Technology Commission,the CAS Focused Science Grant,the IHEP Innovation Grant,the CAS Lead Special Training Programthe CAS Center for Excellence in Particle Physics,the CAS International Partnership Program,and the CAS/SAFEA International Partnership Program for Creative Research Teams.
文摘The Circular Electron Positron Collider(CEPC)is a large scientific project initiated and hosted by China,fostered through extensive collaboration with international partners.The complex comprises four accelerators:a 30 GeV Linac,a 1.1 GeV Damping Ring,a Booster capable of achieving energies up to 180 GeV,and a Collider operating at varying energy modes(Z,W,H,and tt).The Linac and Damping Ring are situated on the surface,while the subterranean Booster and Collider are housed in a 100 km circumference underground tunnel,strategically accommodating future expansion with provisions for a potential Super Proton Proton Collider(SPPC).The CEPC primarily serves as a Higgs factory.In its baseline design with synchrotron radiation(SR)power of 30 MW per beam,it can achieve a luminosity of 5×10^(34)cm^(-2)s^(-1)per interaction point(IP),resulting in an integrated luminosity of 13 ab^(-1)for two IPs over a decade,producing 2.6 million Higgs bosons.Increasing the SR power to 50 MW per beam expands the CEPC's capability to generate 4.3 million Higgs bosons,facilitating precise measurements of Higgs coupling at sub-percent levels,exceeding the precision expected from the HL-LHC by an order of magnitude.This Technical Design Report(TDR)follows the Preliminary Conceptual Design Report(Pre-CDR,2015)and the Conceptual Design Report(CDR,2018),comprehensively detailing the machine's layout,performance metrics,physical design and analysis,technical systems design,R&D and prototyping efforts,and associated civil engineering aspects.Additionally,it includes a cost estimate and a preliminary construction timeline,establishing a framework for forthcoming engineering design phase and site selection procedures.Construction is anticipated to begin around 2027-2028,pending government approval,with an estimated duration of 8 years.The commencement of experiments and data collection could potentially be initiated in the mid-2030s.
文摘Objective: Increasing the emergence of Metallo-β-lactamase (MBL) producing gram-negative bacteria and their dexterous horizontal transmission demands rapid and accurate detection. This study was conducted to determine a suitable method to promptly detect MBL-producing gram-negative bacteria. Methods: A total of 103 gram-negative bacteria were identified from various clinical samples at a tertiary care hospital in Dhaka city. MBL producers were detected by two phenotypic methods, the Disk Potentiation Test (DPT) and the Double Disk Synergy Test (DDST) based on β-lactam chelator combinations where EDTA/SMA has been used as an inhibitor and Imipenem, Ceftazidime as substrates. Results: 103 isolates which were identified as Escherichia coli spp, Klebsiella spp, Pseudomonas spp, Acinetobacter spp, Proteus spp, Providencia spp were found to be multidrug-resistant in antibiogram test. Isolates showed complete resistance (100%) to Imipenem, Meropenem, and Amoxiclav. The highest carbapenem-resistant etiological agents were Acinetobacter spp 40 (38.8%) followed by Pseudomonas spp 27 (26.2%), Klebsiella spp 26 (25.2%), Escherichia coli 8 (7.8%), Proteus spp 1 (1%) and Providencia spp 1 (1%). DPT method detected significantly (p = 0.000009) a higher number of MBL-producers (Imipenem with 0.5 M EDTA n = 61, 59.2% & Ceftazidime with 0.5 M EDTA n = 56, 54.4%) compared to the DDST method (Imipenem -0.5 M EDTA n = 43, 41.7%, Imipenem – SMA n = 38, 36.9% & Ceftazidime -0.5 M EDTA n = 15, 14.6%). Conclusion: Pieces of evidence suggest that DPT is a more sensitive method than DDST and could be recommended for identifying MBL-producing bacteria in Bangladeshi hospitals for the proper management of patients, to reduce time constraints and treatment costs.
基金supported by the Chinese Academy of Sciencesthe National Key R&D Program of China+22 种基金the CAS Center for Excellence in Particle PhysicsWuyi Universitythe Tsung-Dao Lee Institute of Shanghai Jiao Tong University in Chinathe Institut National de Physique Nucléaire et de Physique de Particules (IN2P3) in Francethe Istituto Nazionale di Fisica Nucleare (INFN) in Italythe Italian-Chinese collaborative research program MAECI-NSFCthe Fond de la Recherche Scientifique (F.R.S-FNRS)FWO under the "Excellence of Science-EOS" in Belgiumthe Conselho Nacional de Desenvolvimento Científico e Tecnològico in Brazilthe Agencia Nacional de Investigacion y Desarrollo in Chilethe Charles University Research Centrethe Ministry of Education,Youth,and Sports in Czech Republicthe Deutsche Forschungsgemeinschaft (DFG)the Helmholtz Associationthe Cluster of Excellence PRISMA+ in Germanythe Joint Institute of Nuclear Research (JINR)Lomonosov Moscow State University in Russiathe joint Russian Science Foundation (RSF)National Natural Science Foundation of China (NSFC) research programthe MOST and MOE in Taiwan,Chinathe Chulalongkorn UniversitySuranaree University of Technology in Thailandthe University of California at Irvine in USA
文摘The Jiangmen Underground Neutrino Observatory(JUNO)is a large liquid scintillator detector designed to explore many topics in fundamental physics.In this study,the potential of searching for proton decay in the p→νK^(+)mode with JUNO is investigated.The kaon and its decay particles feature a clear three-fold coincidence signature that results in a high efficiency for identification.Moreover,the excellent energy resolution of JUNO permits suppression of the sizable background caused by other delayed signals.Based on these advantages,the detection efficiency for the proton decay via p→νK^(+)is 36.9%±4.9%with a background level of 0.2±0.05(syst)±0.2(stat)events after 10 years of data collection.The estimated sensitivity based on 200 kton-years of exposure is 9.6×1033 years,which is competitive with the current best limits on the proton lifetime in this channel and complements the use of different detection technologies.
基金supported by the Australian Centre for International Agricultural Research.
文摘Gender inclusiveness is important in the rural transformation process of Bangladesh as rural women play key roles in both agricultural and non-agricultural sectors.Gender inclusiveness also leads to gender equity.We empirically evaluate relationships between rural transformation and gender inclusiveness in Bangladesh.We consider three rural transformation indicators:high-value commodities’share in agricultural output values,non-farm employment’s share in rural labor employment,and non-agricultural GDP’s share in total GDP.Indicators capturing gender inclusiveness include the per capita rural income of males and females,ratio of investments into gender programs,female access to education,access to healthcare,employment participation,land ownership,and asset ownership.We test the effect of the difference in per capita rural income of males and females and the ratio of their incomes and check for the robustness of the gender variables across different model specifications.Analyzing 128 district-level observations from 32 districts of Bangladesh across four time periods(2000,2005,2010 and 2016),we use both ordinary least squares and fixed effects panel regression models.We find that female land and asset ownership and access to education and healthcare are robust determinants of various stages of rural transformation.Thus,our results suggest that improving women’s ownership of land and assets and investing in women’s education and healthcare will likely contribute to a more inclusive rural transformation.
基金the NIH(R01EB021308)Boston University for funding and supporting this research.
文摘Burn wounds result from exposure to hot liquids,chemicals,fire,electric discharge or radiation.Wound severity ranges from first-degree injury,which is superficial,to fourth-degree injury,which exposes bone,tendons and muscles.Rapid assessment of burn depth and accurate wound management in the outpatient setting is critical to prevent injury progression into deeper layers of the dermis.Injury progression is of particular pertinence to second-degree burns,which are the most common form of thermal burn.As our understanding of wound healing advances,treatment options and technologies for second-degree burn management also evolve.Polymeric hydrogels are a class of burn wound dressings that adhere to tissue,absorb wound exudate,protect from the environment,can be transparent facilitating serial wound evaluation and,in some cases,enable facile removal for dressing changes.This review briefly describes the burn level classification and common,commercially available dressings used to treat second-degree burns,and then focuses on new polymeric hydrogel burn dressings under preclinical development analyzing their design,structure and performance.The review presents the follow key learning points:(1)introduction to the integument system and the wound-healing process;(2)classification of burns according to severity and clinical appearance;(3)available dressings currently used for second-degree burns;(4)introduction to hydrogels and their preparation and characterization techniques;and(5)pre-clinical hydrogel burn wound dressings currently being developed.
文摘AIM: To clarify the pathogenesis of gastroesophageal reflux disease symptoms in non-erosive reflux disease(NERD) patients.METHODS: Thirty-five NERD patients with persistent symptoms, despite taking rabeprazole 10 mg twice daily for at least 8 wk, were included in this study. All patients underwent 24 h combined impedance- p H on rabeprazole. The symptom index(SI) was considered to be positive if ≥ 50%, and proximal reflux episodes were determined when reflux reached 15 cm above the proximal margin of the lower esophageal sphincter.RESULTS: In 14(40%) SI-positive patients, with liquid weakly acid reflux, the occurrence rate of reflux symptoms was significantly more frequent in proximal reflux episodes(46.7%) than in distal ones(5.7%)(P < 0.001). With liquid acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(38.5%) and distal ones(20.5%)(NS). With mixed liquid-gas weakly acid reflux, the occurrence rate of reflux symptoms in proximal reflux episodes was significantly more frequent(31.0%) than in distal reflux ones(3.3%)(P < 0.001). With mixed liquid-gas acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(29.4%) and distal ones(14.3%)(NS).CONCLUSION: The proximal extent of weakly acidic liquid and mixed liquid-gas reflux is a major factor associated with reflux perception in SI-positive patients on proton pump inhibitor therapy.
基金supported by the Consejo Superior de Deportes-High Council for Sports in Spain (CSD-089/ UPB10/11)grant from the Ministerio de Educación, Cultura y Deporte, Spain (AP20105476)
文摘Purpose: This study aims to analyze the effects of a 3-month vigorous physical activity(VPA) intervention on eating behavior and body composition in overweight and obese children and adolescents.Methods: Forty-seven participants(7–16 years) took part in the study: 28 were assigned to the intervention group(IG)(10 boys and 18 girls) and19 in a control group(CG)(8 boys and 11 girls). Body composition(dual-energy X-ray absorptiometry), anthropometrics(body mass, height, and body mass index(BMI)), and eating behavior traits(Three-Factor Eating Questionnaire-R21 C) were determined before and after the VPA intervention.Results: A decrease in the percentage of body fat and BMI(-2.8% and-1.8%, respectively), and an increase in most lean mass variables were found in the IG(all p ≤ 0.05). In relation to the eating behavior traits, IG subjects showed a 14% reduction in the Emotional Eating score(p = 0.04),while Cognitive Restraint score did not change after the VPA intervention. The baseline factors of the questionnaire predicted changes in body mass and fat mass variables only in the CG.Conclusion: A 3-month VPA intervention influenced eating behaviors of overweight or obese young, especially the Emotional Eating factor, in the presence of favorable body composition changes.
