目的对心脏植入式电子设备植入术后术侧肢体出现的各种功能障碍的评估内容及早期功能锻炼进行范围综述,为未来早期识别不同的术侧肢体功能障碍和对术后进行早期康复锻炼指导提供参考。方法根据范围综述的研究方法,检索PubMed、Embase、C...目的对心脏植入式电子设备植入术后术侧肢体出现的各种功能障碍的评估内容及早期功能锻炼进行范围综述,为未来早期识别不同的术侧肢体功能障碍和对术后进行早期康复锻炼指导提供参考。方法根据范围综述的研究方法,检索PubMed、Embase、Cochrane Library、Web of Science、CINAHL、中国知网、维普数据库、万方数据库、中国生物医学文献数据库。检索时限为建库至2023年10月31日。对纳入文献进行分析和讨论。结果最终纳入15篇文献。包括随机对照试验7篇、队列研究6篇,病例对照研究2篇。心脏植入式电子设备植入术后术侧肢体相关功能障碍包括肩关节疼痛、肩关节活动范围受限(屈曲、外展、内外旋角度受限)、握力降低和肩胛骨运动障碍,肩关节疼痛和主动前屈受损发生率最高,分别达到61%和60%,主要是植入式心律转复除颤器(ICD)植入术后患者。评估工具包括主观工具和客观工具,评估肩关节疼痛的3种量表,评估肩关节活动范围的测角仪、评估握力的液压手测力仪、评估肩胛骨运动障碍的试验和卷尺、评估肩术侧肢体整体功能的5种量表。术侧肢体的各种相关功能障碍基本表现在术后2周时出现,术后3个月时开始好转,术后12个月时基本趋于正常,术后5年完全恢复,持续时间最长的是ICD植入患者;康复运动方案包括5种,其中钟摆运动是单一方案,其余4种均是综合康复运动方案,均有成效;干预时间点有术后1~2 d,术后1周,术后2周。结论心脏植入式电子设备植入术后需要重点关注术侧肢体存在的系列相关功能障碍,评估工具多样化,应根据测量重点进行合适选择;虽然都有自限性,但自愈时间还是比较长,术后1年内在门诊定期复诊时需要纳入筛查,对其进行综合性干预;患者进行综合功能锻炼方案有利于降低术侧肢体不同功能障碍的发生率,缩短功能障碍的时间,具有进一展开更多
Poly-and perfluoroalkyl substances(PFASs)are important environmental contaminants globally and in the early 2000s they were shown to be ubiquitous contaminants in Arctic wildlife.Previous reviews by Butt et al.and Let...Poly-and perfluoroalkyl substances(PFASs)are important environmental contaminants globally and in the early 2000s they were shown to be ubiquitous contaminants in Arctic wildlife.Previous reviews by Butt et al.and Letcher et al.have covered studies on levels and trends of PFASs in the Arctic that were available to 2009.The purpose of this review is to focus on more recent work,generally published between 2009 and 2018,with emphasis on PFASs of emerging concern such as perfluoroalkyl carboxylates(PFCAs)and short-chain perfluoroalkyl sulfonates(PFSAs)and their precursors.Atmospheric measurements over the period 2006e2014 have shown that fluorotelomer alcohols(FTOHs)as well as perfluorobutanoic acid(PFBA)and perfluoroctanoic acid(PFOA)are the most prominent PFASs in the arctic atmosphere,all with increasing concentrations at Alert although PFOA concentrations declined at the Zeppelin Station(Svalbard).Results from ice cores show generally increasing deposition of PFCAs on the Devon Ice cap in the Canadian arctic while declining fluxes were found in a glacier on Svalbard.An extensive dataset exists for long-term trends of long-chain PFCAs that have been reported in Arctic biota with some datasets including archived samples from the 1970s and 1980s.Trends in PFCAs over time vary among the same species across the North American Arctic,East and West Greenland,and Svalbard.Most long term time series show a decline from higher concentrations in the early 2000s.However there have been recent(post 2010)increasing trends of PFCAs in ringed seals in the Canadian Arctic,East Greenland polar bears and in arctic foxes in Svalbard.Annual biological sampling is helping to determine these relatively short term changes.Rising levels of some PFCAs have been explained by continued emissions of long-chain PFCAs and/or their precursors and inflows to the Arctic Ocean,especially from the North Atlantic.While the effectiveness of biological sampling for temporal trends in long-chain PFCAs and PFSAs has been demonstrated,this does not appl展开更多
Recent years have witnessed a proliferation of quantitative methods for biogeographic inference. In particular, novel parametric approaches represent exciting new opportunities for the study of range evolution. Here, ...Recent years have witnessed a proliferation of quantitative methods for biogeographic inference. In particular, novel parametric approaches represent exciting new opportunities for the study of range evolution. Here, we review a selection of current methods for biogeographic analysis and discuss their respective properties. These methods include generalized parsimony approaches, weighted ancestral area analysis, dispersal-vicariance analysis, the dispersal--extinction--cladogenesis model and other maximum likelihood approaches, and Bayesian stochastic mapping of ancestral ranges, including a novel approach to inferring range evolution in the context of island biogeography. Some of these methods were developed specifically for problems of ancestral range reconstruction, whereas others were designed for more general problems of character state reconstruction and subsequently applied to the study of ancestral ranges. Methods for reconstructing ancestral history on a phylogenetic tree differ not only in the types of ancestral range states that are allowed, but also in the various historical events that may change the ancestral ranges. We explore how the form of allowed ancestral ranges and allowed transitions can both affect the outcome of ancestral range estimation. Finally, we mention some promising avenues for future work in the development of model-based approaches to biogeographic analysis.展开更多
Hexachlorobutadiene(HCBD)is a halogenated hydrocarbon that is primarily produced as an unintentional byproduct in the manufacture of chlorinated solvents.Similarities between HCBD and other persistent organic pollutan...Hexachlorobutadiene(HCBD)is a halogenated hydrocarbon that is primarily produced as an unintentional byproduct in the manufacture of chlorinated solvents.Similarities between HCBD and other persistent organic pollutants(POPs)led to its listing in 2015 for global regulation under the Stockholm Convention on POPs.HCBD's toxicity and propensity for long-range transport means there is special concern for its potential impacts on Arctic ecosystems.The present review comprehensively summarizes all available information of the occurrence of HCBD in the Arctic environment,including its atmospheric,terrestrial,freshwater and marine ecosystems and biota.Overall,reports of HCBD in Arctic environmental media are scarce.HCBD has been measured in Arctic air collected from monitoring stations in Finland and Canada,yet there is a dearth of data for other abiotic matrices(i.e.soils,sediments,glacier ice,freshwaters and seawater).Low HCBD concentrations have been measured in Arctic terrestrial and marine biota,which is consistent with laboratory studies that indicate that HCBD has the potential to bioaccumulate,but not to biomagnify.Available data for Arctic biota suggest that terrestrial birds and mammals and seabirds,have comparatively higher HCBD concentrations than fish and marine mammals,warranting additional research.Although spatial and temporal trends in HCBD concentrations in the Arctic are currently limited,future monitoring of HCBD in the Arctic will be important for assessing the impact of global regulations newly-imposed by the Stockholm Convention on POPs.展开更多
Exercise is proven to be effective, safe and the preferred intervention for improving the range of shoulder motion of breast cancer patients who have undergone surgery for axillary lymph-node dissection. The applicati...Exercise is proven to be effective, safe and the preferred intervention for improving the range of shoulder motion of breast cancer patients who have undergone surgery for axillary lymph-node dissection. The application of evidence-based guidelines to clinical practice can help healthcare professionals to provide good quality care to patients and, in turn, produce better patient outcomes. The purpose of the present paper is to describe the development process of an evidenced-based guideline. Challenges in the implementation of evidence-based practice are identi.ed and strategies for tackling them discussed.展开更多
文摘目的对心脏植入式电子设备植入术后术侧肢体出现的各种功能障碍的评估内容及早期功能锻炼进行范围综述,为未来早期识别不同的术侧肢体功能障碍和对术后进行早期康复锻炼指导提供参考。方法根据范围综述的研究方法,检索PubMed、Embase、Cochrane Library、Web of Science、CINAHL、中国知网、维普数据库、万方数据库、中国生物医学文献数据库。检索时限为建库至2023年10月31日。对纳入文献进行分析和讨论。结果最终纳入15篇文献。包括随机对照试验7篇、队列研究6篇,病例对照研究2篇。心脏植入式电子设备植入术后术侧肢体相关功能障碍包括肩关节疼痛、肩关节活动范围受限(屈曲、外展、内外旋角度受限)、握力降低和肩胛骨运动障碍,肩关节疼痛和主动前屈受损发生率最高,分别达到61%和60%,主要是植入式心律转复除颤器(ICD)植入术后患者。评估工具包括主观工具和客观工具,评估肩关节疼痛的3种量表,评估肩关节活动范围的测角仪、评估握力的液压手测力仪、评估肩胛骨运动障碍的试验和卷尺、评估肩术侧肢体整体功能的5种量表。术侧肢体的各种相关功能障碍基本表现在术后2周时出现,术后3个月时开始好转,术后12个月时基本趋于正常,术后5年完全恢复,持续时间最长的是ICD植入患者;康复运动方案包括5种,其中钟摆运动是单一方案,其余4种均是综合康复运动方案,均有成效;干预时间点有术后1~2 d,术后1周,术后2周。结论心脏植入式电子设备植入术后需要重点关注术侧肢体存在的系列相关功能障碍,评估工具多样化,应根据测量重点进行合适选择;虽然都有自限性,但自愈时间还是比较长,术后1年内在门诊定期复诊时需要纳入筛查,对其进行综合性干预;患者进行综合功能锻炼方案有利于降低术侧肢体不同功能障碍的发生率,缩短功能障碍的时间,具有进一
基金We thank the Arctic Monitoring and Assessment Programme(AMAP)and the national programs in the circumpolar countries for their funding and support of this work.We are especially grateful to Simon Wilson,Cynthia de Wit,and the reviewers that read the chapter on PFASs in the original AMAP assessment.We are thankful to the northern communities in circumpolar regions for their cooperation and collection of biological samples that yielded the data reviewed here.DCGM was supported by the King Carl XVI Gustaf Professorship in Environmental Science at the Dept of Environmental Science and Analytical Chemistry,Stockholm University during 2018-19.
文摘Poly-and perfluoroalkyl substances(PFASs)are important environmental contaminants globally and in the early 2000s they were shown to be ubiquitous contaminants in Arctic wildlife.Previous reviews by Butt et al.and Letcher et al.have covered studies on levels and trends of PFASs in the Arctic that were available to 2009.The purpose of this review is to focus on more recent work,generally published between 2009 and 2018,with emphasis on PFASs of emerging concern such as perfluoroalkyl carboxylates(PFCAs)and short-chain perfluoroalkyl sulfonates(PFSAs)and their precursors.Atmospheric measurements over the period 2006e2014 have shown that fluorotelomer alcohols(FTOHs)as well as perfluorobutanoic acid(PFBA)and perfluoroctanoic acid(PFOA)are the most prominent PFASs in the arctic atmosphere,all with increasing concentrations at Alert although PFOA concentrations declined at the Zeppelin Station(Svalbard).Results from ice cores show generally increasing deposition of PFCAs on the Devon Ice cap in the Canadian arctic while declining fluxes were found in a glacier on Svalbard.An extensive dataset exists for long-term trends of long-chain PFCAs that have been reported in Arctic biota with some datasets including archived samples from the 1970s and 1980s.Trends in PFCAs over time vary among the same species across the North American Arctic,East and West Greenland,and Svalbard.Most long term time series show a decline from higher concentrations in the early 2000s.However there have been recent(post 2010)increasing trends of PFCAs in ringed seals in the Canadian Arctic,East Greenland polar bears and in arctic foxes in Svalbard.Annual biological sampling is helping to determine these relatively short term changes.Rising levels of some PFCAs have been explained by continued emissions of long-chain PFCAs and/or their precursors and inflows to the Arctic Ocean,especially from the North Atlantic.While the effectiveness of biological sampling for temporal trends in long-chain PFCAs and PFSAs has been demonstrated,this does not appl
基金support from the National Institute of Environmental Health Sciences (USA) training grant to the NCSU Bioinformatics Research Centersupported by National Institutes of Health (USA) grant no.GM070806
文摘Recent years have witnessed a proliferation of quantitative methods for biogeographic inference. In particular, novel parametric approaches represent exciting new opportunities for the study of range evolution. Here, we review a selection of current methods for biogeographic analysis and discuss their respective properties. These methods include generalized parsimony approaches, weighted ancestral area analysis, dispersal-vicariance analysis, the dispersal--extinction--cladogenesis model and other maximum likelihood approaches, and Bayesian stochastic mapping of ancestral ranges, including a novel approach to inferring range evolution in the context of island biogeography. Some of these methods were developed specifically for problems of ancestral range reconstruction, whereas others were designed for more general problems of character state reconstruction and subsequently applied to the study of ancestral ranges. Methods for reconstructing ancestral history on a phylogenetic tree differ not only in the types of ancestral range states that are allowed, but also in the various historical events that may change the ancestral ranges. We explore how the form of allowed ancestral ranges and allowed transitions can both affect the outcome of ancestral range estimation. Finally, we mention some promising avenues for future work in the development of model-based approaches to biogeographic analysis.
基金We thank the Arctic Monitoring and Assessment Programme(AMAP)and the national programs in the circumpolar countries for their funding and support of this work.We are especially grateful to Simon Wilson,Cynthia de Wit,and the numerous reviewers that were a part of this process.We are thankful to the northern communities in circumpolar regions for their cooperation and collection of biological samples that yielded much of the data reviewed here.Katrin Vorkamp's contribution to the AMAP assessment report was supported by the Danish Environmental Protection Agency,under the Cooperation for Environment in the Arctic(DANCEA),grants no.MST-112-191 and MST-113-00082.We also thank Canada's Northern Contaminants Program(NCP)for providing air data from the station of Alert.Unpublished results were provided by D.C.G.Muir,M.Evans,and H.Hung(Environment and Climate Change Canada),and K.Vorkamp and F.Riget(Aarhus University,Denmark).
文摘Hexachlorobutadiene(HCBD)is a halogenated hydrocarbon that is primarily produced as an unintentional byproduct in the manufacture of chlorinated solvents.Similarities between HCBD and other persistent organic pollutants(POPs)led to its listing in 2015 for global regulation under the Stockholm Convention on POPs.HCBD's toxicity and propensity for long-range transport means there is special concern for its potential impacts on Arctic ecosystems.The present review comprehensively summarizes all available information of the occurrence of HCBD in the Arctic environment,including its atmospheric,terrestrial,freshwater and marine ecosystems and biota.Overall,reports of HCBD in Arctic environmental media are scarce.HCBD has been measured in Arctic air collected from monitoring stations in Finland and Canada,yet there is a dearth of data for other abiotic matrices(i.e.soils,sediments,glacier ice,freshwaters and seawater).Low HCBD concentrations have been measured in Arctic terrestrial and marine biota,which is consistent with laboratory studies that indicate that HCBD has the potential to bioaccumulate,but not to biomagnify.Available data for Arctic biota suggest that terrestrial birds and mammals and seabirds,have comparatively higher HCBD concentrations than fish and marine mammals,warranting additional research.Although spatial and temporal trends in HCBD concentrations in the Arctic are currently limited,future monitoring of HCBD in the Arctic will be important for assessing the impact of global regulations newly-imposed by the Stockholm Convention on POPs.
文摘Exercise is proven to be effective, safe and the preferred intervention for improving the range of shoulder motion of breast cancer patients who have undergone surgery for axillary lymph-node dissection. The application of evidence-based guidelines to clinical practice can help healthcare professionals to provide good quality care to patients and, in turn, produce better patient outcomes. The purpose of the present paper is to describe the development process of an evidenced-based guideline. Challenges in the implementation of evidence-based practice are identi.ed and strategies for tackling them discussed.
