A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and wei...A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and weight loss surgery. Endoscopic procedures have the potential to bridge the gap between medical therapy and surgery. Current primary endoscopic bariatric therapies can be classified as restrictive, bypass, spaceoccupying, or aspiration therapy. Restrictive procedures include the USGI Primary Obesity Surgery Endolumenal procedure, endoscopic sleeve gastroplasty using Apollo Over Stitch, Trans Oral GAstroplasty, gastric volume reduction using the ACE stapler, and insertion of the TERIS restrictive device. Intestinal bypass has been reported using the EndoB arrier duodenal-jejunal bypass liner. A number of space-occupying devices have been studied or are in use, including intragastric balloons(Orbera, Reshape Duo, Heliosphere BAG, Obalon), Transpyloric Shuttle, and Sati Sphere. The Aspire Assist aspiration system has demonstrated efficacy. Finally, endoscopic revision of gastric bypass to address weight regain has been studied using Apollo Over Stitch, the USGI Incisionless Operating Platform Revision Obesity Surgery Endolumenal procedure, Stomaphyx, and endoscopic sclerotherapy. Endoscopic therapies for weight loss are potentially reversible, repeatable, less invasive, and lower cost than various medical and surgical alternatives. Given the variety of devices under development, in clinical trials, and currently in use, patients will have multiple endoscopic options with greater efficacy than medical therapy, and with lower invasiveness and greater accessibility than surgery.展开更多
During the pre-Qin period,shi yan zhi(poetry expressing aspirations)was not a poetic concept.It primarily served to shape Confucian ideology,carrying significant discourse implications.The practices of shi yan zhi and...During the pre-Qin period,shi yan zhi(poetry expressing aspirations)was not a poetic concept.It primarily served to shape Confucian ideology,carrying significant discourse implications.The practices of shi yan zhi and bi zhi in religious rituals held important implications for poem reciting,a prevalent activity during the banquet ceremonies in the Spring and Autumn Period and its various forms.Together,they established the rites and music tradition characterized by yanshuo(speeches).This tradition further established the status of The Book of Odes as a classic,furnishing high-ranking officials and Confucian scholars with legitimacy and rich discourse resources to develop new ideologies.The different interpretations and applications of shi yan zhi resulted in diverse discourse models,such as duanzhang-quyi(to interpret out of context),xin’er youzheng(being reliable and borne out by evidence),wenwang yinyan(no word,no expression of thoughts)and yiyi-nizhi(interpreting a writing from one’s perspective).Through these different interpretations and applications,the scholarly-official class established multiple values and objectives,such as liyan buxiu(advocating lasting noble ideas untouched by time),xing-guan-qun yuan(stimulation,contemplation,communication,and criticism),shang you(befriending those superior to oneself),fa hu qing,zhi hu li yi(starting with feelings and control with propriety).In the process of building a unified ideology in the Han Dynasty,the“Introduction to Mao’s Version of The Book of Odes”advocated the unity of qing(sentiment)and zhi(aspiration),infusing shi yan zhi with connotations of enlightenment as well as extolment and satirical criticism.This advocacy redefined the political authority and discourse models of the scholar-official class,objectively unveiling the literary features of poetry,such as evoking an emotional response and commencing the practice of education through poetry teaching.展开更多
Small intestinal bacterial overgrowth has been found to be associated with a variety of gastrointestinal disorders such as irritable bowel syndrome, inflammatory bowel disease, and, in recent years, diabetes mellitus ...Small intestinal bacterial overgrowth has been found to be associated with a variety of gastrointestinal disorders such as irritable bowel syndrome, inflammatory bowel disease, and, in recent years, diabetes mellitus and systemic sclerosis, among other extraintestinal diseases. Several novel diagnostic tools for small intestinal bacterial overgrowth have emerged in recent years, and several therapeutic approaches have been proposed. Therefore, it has become necessary to find an effective, safe, and simple diagnostic method and a safe treatment modality. This article provides a review of current diagnostic and therapeutic approaches to small intestinal bacterial overgrowth.展开更多
Acute leukemia (AL) is a malignant disease of the bone marrow in which hematopoietic precursors are arrested in an early stage of development. The diagnosis of leukemia and lymphomas, beyond morphology, is limited in ...Acute leukemia (AL) is a malignant disease of the bone marrow in which hematopoietic precursors are arrested in an early stage of development. The diagnosis of leukemia and lymphomas, beyond morphology, is limited in low-resource countries including Kenya. Morphological diagnosis includes Cytological and Histological assessment of blood, bone marrow aspirates and tissues on suspected Acute leukemia patients. The World Health Organization (WHO, 2016) international guidelines on Acute leukemia diagnosis recommend that cytogenetic analysis, appropriate molecular genetics, Fluorescent in situ Hybridization (FISH) testing, and flow cytometric immuno-phenotyping should be done in addition to a morphologic assessment of Acute Leukemia. In facilities where resources are relatively available, immunophenotypic and genetic features have resulted not only in providing a more accurate leukemia diagnosis but also in identifying antigens or genes that can then be targeted for therapy. This article will look at the gaps in the diagnosis of Acute leukemia in low-resource settings like Kenya and opportunities available to improve diagnosis.展开更多
The study explores the yearnings of fisherfolks on their child’s education, hindrances, and factors that shape their desire as parents. Field observations and key informant interview among elder members of fisherfolk...The study explores the yearnings of fisherfolks on their child’s education, hindrances, and factors that shape their desire as parents. Field observations and key informant interview among elder members of fisherfolk communities surrounding the Albay, Ragay, and Asid Gulfs of the Bicol Region was utilized. The study revealed that the majority of the fisherfolk parents do not want their children to continue fishing as their main source of livelihood because of potential risks, hardships, and cultural factors like collectivism, close family ties, and dependence on the elders. The parents’ aspirations were shaped by their persistence over various threats, fears, personal unfulfilled dreams, and career opportunities thru education. Most of the parents desired a college education and a safe and secure profession for their children. The study deduced that these challenges can be a contributory factor for the declining number of fisherfolks surrounding the gulfs. Influencing this sector is the factor motivating fishers in their aspirations for their children’s education. The study recommends introducing strategies for fisherfolks to develop a strong sense of hope and drive in realizing their aspirations and further research on the impact of culture, the role of women and children, and fisherfolks and their success stories.展开更多
文摘A new paradigm in the treatment of obesity and metabolic disease is developing. The global obesity epidemic continues to expand despite the availability of diet and lifestyle counseling, pharmacologic therapy, and weight loss surgery. Endoscopic procedures have the potential to bridge the gap between medical therapy and surgery. Current primary endoscopic bariatric therapies can be classified as restrictive, bypass, spaceoccupying, or aspiration therapy. Restrictive procedures include the USGI Primary Obesity Surgery Endolumenal procedure, endoscopic sleeve gastroplasty using Apollo Over Stitch, Trans Oral GAstroplasty, gastric volume reduction using the ACE stapler, and insertion of the TERIS restrictive device. Intestinal bypass has been reported using the EndoB arrier duodenal-jejunal bypass liner. A number of space-occupying devices have been studied or are in use, including intragastric balloons(Orbera, Reshape Duo, Heliosphere BAG, Obalon), Transpyloric Shuttle, and Sati Sphere. The Aspire Assist aspiration system has demonstrated efficacy. Finally, endoscopic revision of gastric bypass to address weight regain has been studied using Apollo Over Stitch, the USGI Incisionless Operating Platform Revision Obesity Surgery Endolumenal procedure, Stomaphyx, and endoscopic sclerotherapy. Endoscopic therapies for weight loss are potentially reversible, repeatable, less invasive, and lower cost than various medical and surgical alternatives. Given the variety of devices under development, in clinical trials, and currently in use, patients will have multiple endoscopic options with greater efficacy than medical therapy, and with lower invasiveness and greater accessibility than surgery.
文摘During the pre-Qin period,shi yan zhi(poetry expressing aspirations)was not a poetic concept.It primarily served to shape Confucian ideology,carrying significant discourse implications.The practices of shi yan zhi and bi zhi in religious rituals held important implications for poem reciting,a prevalent activity during the banquet ceremonies in the Spring and Autumn Period and its various forms.Together,they established the rites and music tradition characterized by yanshuo(speeches).This tradition further established the status of The Book of Odes as a classic,furnishing high-ranking officials and Confucian scholars with legitimacy and rich discourse resources to develop new ideologies.The different interpretations and applications of shi yan zhi resulted in diverse discourse models,such as duanzhang-quyi(to interpret out of context),xin’er youzheng(being reliable and borne out by evidence),wenwang yinyan(no word,no expression of thoughts)and yiyi-nizhi(interpreting a writing from one’s perspective).Through these different interpretations and applications,the scholarly-official class established multiple values and objectives,such as liyan buxiu(advocating lasting noble ideas untouched by time),xing-guan-qun yuan(stimulation,contemplation,communication,and criticism),shang you(befriending those superior to oneself),fa hu qing,zhi hu li yi(starting with feelings and control with propriety).In the process of building a unified ideology in the Han Dynasty,the“Introduction to Mao’s Version of The Book of Odes”advocated the unity of qing(sentiment)and zhi(aspiration),infusing shi yan zhi with connotations of enlightenment as well as extolment and satirical criticism.This advocacy redefined the political authority and discourse models of the scholar-official class,objectively unveiling the literary features of poetry,such as evoking an emotional response and commencing the practice of education through poetry teaching.
文摘Small intestinal bacterial overgrowth has been found to be associated with a variety of gastrointestinal disorders such as irritable bowel syndrome, inflammatory bowel disease, and, in recent years, diabetes mellitus and systemic sclerosis, among other extraintestinal diseases. Several novel diagnostic tools for small intestinal bacterial overgrowth have emerged in recent years, and several therapeutic approaches have been proposed. Therefore, it has become necessary to find an effective, safe, and simple diagnostic method and a safe treatment modality. This article provides a review of current diagnostic and therapeutic approaches to small intestinal bacterial overgrowth.
文摘Acute leukemia (AL) is a malignant disease of the bone marrow in which hematopoietic precursors are arrested in an early stage of development. The diagnosis of leukemia and lymphomas, beyond morphology, is limited in low-resource countries including Kenya. Morphological diagnosis includes Cytological and Histological assessment of blood, bone marrow aspirates and tissues on suspected Acute leukemia patients. The World Health Organization (WHO, 2016) international guidelines on Acute leukemia diagnosis recommend that cytogenetic analysis, appropriate molecular genetics, Fluorescent in situ Hybridization (FISH) testing, and flow cytometric immuno-phenotyping should be done in addition to a morphologic assessment of Acute Leukemia. In facilities where resources are relatively available, immunophenotypic and genetic features have resulted not only in providing a more accurate leukemia diagnosis but also in identifying antigens or genes that can then be targeted for therapy. This article will look at the gaps in the diagnosis of Acute leukemia in low-resource settings like Kenya and opportunities available to improve diagnosis.
文摘The study explores the yearnings of fisherfolks on their child’s education, hindrances, and factors that shape their desire as parents. Field observations and key informant interview among elder members of fisherfolk communities surrounding the Albay, Ragay, and Asid Gulfs of the Bicol Region was utilized. The study revealed that the majority of the fisherfolk parents do not want their children to continue fishing as their main source of livelihood because of potential risks, hardships, and cultural factors like collectivism, close family ties, and dependence on the elders. The parents’ aspirations were shaped by their persistence over various threats, fears, personal unfulfilled dreams, and career opportunities thru education. Most of the parents desired a college education and a safe and secure profession for their children. The study deduced that these challenges can be a contributory factor for the declining number of fisherfolks surrounding the gulfs. Influencing this sector is the factor motivating fishers in their aspirations for their children’s education. The study recommends introducing strategies for fisherfolks to develop a strong sense of hope and drive in realizing their aspirations and further research on the impact of culture, the role of women and children, and fisherfolks and their success stories.
