Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known...Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the “pull” technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues. Despite the mentioned PEG tube placement complications, this procedure has gained worldwide popularity as a safe enteral access for nutrition in patients with a functional gastrointestinal system.展开更多
We studied the perception of forest-dependent communities on climate change with its associated risk and their adaptation strategies in Mizoram, Northeast India. A total of 360 respondents (household heads) were rando...We studied the perception of forest-dependent communities on climate change with its associated risk and their adaptation strategies in Mizoram, Northeast India. A total of 360 respondents (household heads) were randomly selected from 24 villages across the three different agro-climatic zones prevalent. The community perceived awareness of climate change phenomena in the region with a positive correlation between age, education and occupation of the respondents. The overall perception of climate change in temperature was medium (0.49), while low for change in precipitation (0.26) and seasonal durability (0.23). The community showed over-all low score of perception on risk of climate change (0.10) where risk on livelihood and socio-economic factors was higher than risk to environment or forest. Perception on impact of climate change was high for forest abi-otic ecological factors (0.66) and flora and fauna (0.62), while medium on livelihood of forest-dependent communities (0.44). The majority (more than 75%) of the respondents agreed that human beings are involved and responsible for climate change. Adoption of adaptive strategies to cope climate change ranged from 0.07 to 0.91, amongst which zero tillage, use of traditional knowledge, forest fire prevention, soil and water conservation techniques, agroforestry practices and social forestry are popular. However, rain water harvesting and investments for crop insurance were adopted on low scores clearly implied by the educational and socio-economic status of the farmers in the majority. The study brings out the knowledge and perceptions to climate change by forest-dependent communities and their adaptive strategies to cope had been assessed. The finding results seek the attention of researchers and policy makers to integrate technological and financial interventions in supporting farmer’s effort to cope with climate change with a long term objective for improving their livelihood and climate sensitive resources at the same time.展开更多
The analyses of δ13C and δ18O of gas hydrate-associated sediments from two cores on Hydrate Ridge in Cascadia convergent margin offshore Oregon, eastern North Pacific show the values of δ13C from-29.81‰ to -48.28...The analyses of δ13C and δ18O of gas hydrate-associated sediments from two cores on Hydrate Ridge in Cascadia convergent margin offshore Oregon, eastern North Pacific show the values of δ13C from-29.81‰ to -48.28‰(PDB) and δ18O from 2.56‰to 4.28‰ (PDB), which could be plotted into a group called typical carbonate minerals influenced by the methane in cold venting. Moreover, the values of δ13C and δ18O show a consistent trend in both cores from top to bottom with increasing of δ13C and decreasing of δ18O. This trend could be explained as an effect caused by the anaerobic oxidation of methane (AOM) in depth and the oxygen fraction during the formation of gas hydrate in depth together. These characteristics of δ13C and δ18O indicate that the gas hydrate-associated sediments are significantly different from the normal marine carbonates, and they are deeply influenced by the formation and evolution of gas hydrate. So, the distinct characteristics of δ13C and δ18O of gas hydrate-associated展开更多
OBJECTIVE: To investigate the prevalence of significant enterococcal isolates from urine and determine what factors are associated with the increased prevalence, with particular reference to antibiotic susceptibilitie...OBJECTIVE: To investigate the prevalence of significant enterococcal isolates from urine and determine what factors are associated with the increased prevalence, with particular reference to antibiotic susceptibilities. METHODS: Retrospective analysis over an 8-year period of hospital laboratory records of urinary isolates of enterococci was done. Species were identified via colony morphology, growth in 6.5% sodium chloride and their ability to hydrolyze esculin in the presence of 40% bile salts. Susceptibility testing via the disc diffusion technique with 9 commonly used antibiotics was also done as defined by the National Committee for Clinical Laboratory Standards. RESULTS: From 39,881 urine specimens, 9116 (22.9%) were culture positive. Of this 9116, 1001 (11.0%) were enterococci, the 4th most common urinary isolate. E. coli was the most common (36.2%). Most enterococci were from pediatric patients (28.4%) and the urology unit (24.5%). All enterococci were fully sensitive to ampicillin and augmentin (amoxicillin-clavulanic acid). Sensitivity to gentamicin decreased significantly from 79% in 1990 to 58% in 1997 (P展开更多
Electronic Medical Records (EMRs) play a crucial role in healthcare systems, providing secure, comprehensive medical information and reducing errors. However, they are often fragmented and stored in separate databases...Electronic Medical Records (EMRs) play a crucial role in healthcare systems, providing secure, comprehensive medical information and reducing errors. However, they are often fragmented and stored in separate databases owned by different institutions (e.g., hospitals, labs, clinics), posing challenges for healthcare professionals in sharing, preserving, and monitoring patients’ EMRs. To address the aforementioned challenges, this paper proposes a framework integrating many new emerging technologies and underscores their pivotal role in revolutionizing EMR systems. In particular, Hyperledger Indy empowers patients with complete authority over their EMRs, while Hyperledger Fabric manages authentication, authorization, and traceability. The InterPlanetary File System (IPFS) is used for secure sharing of EMRs. The Internet of Medical Things (IoMT) achieves real-time monitoring of patients’ health characteristics. Finally, WebAuthn provides strong protection for used cryptographic keys and cryptographic operations.展开更多
T wo summers ago,China’s indie godfathers P.K.14 went on a triumphant 31-date national tour to celebrate their fifth album,1984,their first in five years.American underground music documentarian John Yingling tagged ...T wo summers ago,China’s indie godfathers P.K.14 went on a triumphant 31-date national tour to celebrate their fifth album,1984,their first in five years.American underground music documentarian John Yingling tagged along to film the first episode of his ambitious The World Underground series.The Wisconsin native is taking his passion to the global stage.Armed with“a shitty Canon ELPH,”Yingling moved to Chicago in 2007 to indulge in his long-nurtured love for the Windy City’s music scene.He filmed and photographed hundreds of shows for his Gonzo Chicago blog,eventually being named Best Music Scene Documentarian by The Chicago Reader in 2012.A year later,he did the same thing in Missoula,Montana.展开更多
The British rock renaissance that dominated the early 2000s gave birth to a number of iconic bands,such as The Libertines,the Arctic Monkeys and Bloc Party.These groups have cemented themselves as essentia...The British rock renaissance that dominated the early 2000s gave birth to a number of iconic bands,such as The Libertines,the Arctic Monkeys and Bloc Party.These groups have cemented themselves as essential‘landfill indie,’surviving the test of time and following us from playlist to playlist.展开更多
Amonth away from celebrating its third anniversary,The Sound Stage remains the lone champion for Chinese indie music in state media.Part online video series and part hour-long radio program,the China Radio Internation...Amonth away from celebrating its third anniversary,The Sound Stage remains the lone champion for Chinese indie music in state media.Part online video series and part hour-long radio program,the China Radio International(CRI)show has been growing alongside China's indie scene.展开更多
Increased online streaming regulation?A budding national touring circuit?Glastonbury Festival appearances and DJ Shadow collaborations?For years a paradoxical joke,does the future acturally hold hope for China's i...Increased online streaming regulation?A budding national touring circuit?Glastonbury Festival appearances and DJ Shadow collaborations?For years a paradoxical joke,does the future acturally hold hope for China's indie labels?展开更多
It’s been a wild ride for Danish group Mew.Since forming in 1994 as high school kids“learning how to play from scratch,”they’ve found themselves at the forefront of the Copenhagen underground.Among the first acts ...It’s been a wild ride for Danish group Mew.Since forming in 1994 as high school kids“learning how to play from scratch,”they’ve found themselves at the forefront of the Copenhagen underground.Among the first acts in the country to sign an international major label deal,they’ve toured the world with alternative icons like R.E.M and Nine Inch Nails,while developing a sound they dub“indie-stadium.”展开更多
Since indie rock is often intertwined with purposeful bleakness and irony,the upbeat earnestness of The Pains of Being Pure at Heart is a breath of fresh air.Even so,the poppy sensibility of so many of their songs bel...Since indie rock is often intertwined with purposeful bleakness and irony,the upbeat earnestness of The Pains of Being Pure at Heart is a breath of fresh air.Even so,the poppy sensibility of so many of their songs belies a dark and con-templative emotional core.展开更多
文摘Percutaneous endoscopic gastrostomy (PEG) is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. Besides its well-known advantages over parenteral nutrition, PEG offers superior access to the gastrointestinal system over surgical methods. Considering that nowadays PEG tube placement is one of the most common endoscopic procedures performed worldwide, knowing its indications and contraindications is of paramount importance in current medicine. PEG tubes are sometimes placed inappropriately in patients unable to tolerate adequate oral intake because of incorrect and unrealistic understanding of their indications and what they can accomplish. Broadly, the two main indications of PEG tube placement are enteral feeding and stomach decompression. On the other hand, distal enteral obstruction, severe uncorrectable coagulopathy and hemodynamic instability constitute the main absolute contraindications for PEG tube placement in hospitalized patients. Although generally considered to be a safe procedure, there is the potential for both minor and major complications. Awareness of these potential complications, as well as understanding routine aftercare of the catheter, can improve the quality of care for patients with a PEG tube. These complications can generally be classified into three major categories: endoscopic technical difficulties, PEG procedure-related complications and late complications associated with PEG tube use and wound care. In this review we describe a variety of minor and major tube-related complications as well as strategies for their management and avoidance. Different methods of percutaneous PEG tube placement into the stomach have been described in the literature with the “pull” technique being the most common method. In the last section of this review, the reader is presented with a brief discussion of these procedures, techniques and related issues. Despite the mentioned PEG tube placement complications, this procedure has gained worldwide popularity as a safe enteral access for nutrition in patients with a functional gastrointestinal system.
文摘We studied the perception of forest-dependent communities on climate change with its associated risk and their adaptation strategies in Mizoram, Northeast India. A total of 360 respondents (household heads) were randomly selected from 24 villages across the three different agro-climatic zones prevalent. The community perceived awareness of climate change phenomena in the region with a positive correlation between age, education and occupation of the respondents. The overall perception of climate change in temperature was medium (0.49), while low for change in precipitation (0.26) and seasonal durability (0.23). The community showed over-all low score of perception on risk of climate change (0.10) where risk on livelihood and socio-economic factors was higher than risk to environment or forest. Perception on impact of climate change was high for forest abi-otic ecological factors (0.66) and flora and fauna (0.62), while medium on livelihood of forest-dependent communities (0.44). The majority (more than 75%) of the respondents agreed that human beings are involved and responsible for climate change. Adoption of adaptive strategies to cope climate change ranged from 0.07 to 0.91, amongst which zero tillage, use of traditional knowledge, forest fire prevention, soil and water conservation techniques, agroforestry practices and social forestry are popular. However, rain water harvesting and investments for crop insurance were adopted on low scores clearly implied by the educational and socio-economic status of the farmers in the majority. The study brings out the knowledge and perceptions to climate change by forest-dependent communities and their adaptive strategies to cope had been assessed. The finding results seek the attention of researchers and policy makers to integrate technological and financial interventions in supporting farmer’s effort to cope with climate change with a long term objective for improving their livelihood and climate sensitive resources at the same time.
基金This work was strongly advised by Prof. Dr. Erwin Suess at GEOMAR, Research Center of Marine Geology in University of Kiel, GermanyGreat supports were also from Dr. Gerhard Bohrmann, Dr. Jens Greinert, Dr. Carmen Jung, Dr. Barbara Teichert, Dr. Dick Ri
文摘The analyses of δ13C and δ18O of gas hydrate-associated sediments from two cores on Hydrate Ridge in Cascadia convergent margin offshore Oregon, eastern North Pacific show the values of δ13C from-29.81‰ to -48.28‰(PDB) and δ18O from 2.56‰to 4.28‰ (PDB), which could be plotted into a group called typical carbonate minerals influenced by the methane in cold venting. Moreover, the values of δ13C and δ18O show a consistent trend in both cores from top to bottom with increasing of δ13C and decreasing of δ18O. This trend could be explained as an effect caused by the anaerobic oxidation of methane (AOM) in depth and the oxygen fraction during the formation of gas hydrate in depth together. These characteristics of δ13C and δ18O indicate that the gas hydrate-associated sediments are significantly different from the normal marine carbonates, and they are deeply influenced by the formation and evolution of gas hydrate. So, the distinct characteristics of δ13C and δ18O of gas hydrate-associated
文摘OBJECTIVE: To investigate the prevalence of significant enterococcal isolates from urine and determine what factors are associated with the increased prevalence, with particular reference to antibiotic susceptibilities. METHODS: Retrospective analysis over an 8-year period of hospital laboratory records of urinary isolates of enterococci was done. Species were identified via colony morphology, growth in 6.5% sodium chloride and their ability to hydrolyze esculin in the presence of 40% bile salts. Susceptibility testing via the disc diffusion technique with 9 commonly used antibiotics was also done as defined by the National Committee for Clinical Laboratory Standards. RESULTS: From 39,881 urine specimens, 9116 (22.9%) were culture positive. Of this 9116, 1001 (11.0%) were enterococci, the 4th most common urinary isolate. E. coli was the most common (36.2%). Most enterococci were from pediatric patients (28.4%) and the urology unit (24.5%). All enterococci were fully sensitive to ampicillin and augmentin (amoxicillin-clavulanic acid). Sensitivity to gentamicin decreased significantly from 79% in 1990 to 58% in 1997 (P
文摘Electronic Medical Records (EMRs) play a crucial role in healthcare systems, providing secure, comprehensive medical information and reducing errors. However, they are often fragmented and stored in separate databases owned by different institutions (e.g., hospitals, labs, clinics), posing challenges for healthcare professionals in sharing, preserving, and monitoring patients’ EMRs. To address the aforementioned challenges, this paper proposes a framework integrating many new emerging technologies and underscores their pivotal role in revolutionizing EMR systems. In particular, Hyperledger Indy empowers patients with complete authority over their EMRs, while Hyperledger Fabric manages authentication, authorization, and traceability. The InterPlanetary File System (IPFS) is used for secure sharing of EMRs. The Internet of Medical Things (IoMT) achieves real-time monitoring of patients’ health characteristics. Finally, WebAuthn provides strong protection for used cryptographic keys and cryptographic operations.
文摘T wo summers ago,China’s indie godfathers P.K.14 went on a triumphant 31-date national tour to celebrate their fifth album,1984,their first in five years.American underground music documentarian John Yingling tagged along to film the first episode of his ambitious The World Underground series.The Wisconsin native is taking his passion to the global stage.Armed with“a shitty Canon ELPH,”Yingling moved to Chicago in 2007 to indulge in his long-nurtured love for the Windy City’s music scene.He filmed and photographed hundreds of shows for his Gonzo Chicago blog,eventually being named Best Music Scene Documentarian by The Chicago Reader in 2012.A year later,he did the same thing in Missoula,Montana.
文摘The British rock renaissance that dominated the early 2000s gave birth to a number of iconic bands,such as The Libertines,the Arctic Monkeys and Bloc Party.These groups have cemented themselves as essential‘landfill indie,’surviving the test of time and following us from playlist to playlist.
文摘Amonth away from celebrating its third anniversary,The Sound Stage remains the lone champion for Chinese indie music in state media.Part online video series and part hour-long radio program,the China Radio International(CRI)show has been growing alongside China's indie scene.
文摘Increased online streaming regulation?A budding national touring circuit?Glastonbury Festival appearances and DJ Shadow collaborations?For years a paradoxical joke,does the future acturally hold hope for China's indie labels?
文摘It’s been a wild ride for Danish group Mew.Since forming in 1994 as high school kids“learning how to play from scratch,”they’ve found themselves at the forefront of the Copenhagen underground.Among the first acts in the country to sign an international major label deal,they’ve toured the world with alternative icons like R.E.M and Nine Inch Nails,while developing a sound they dub“indie-stadium.”
文摘Since indie rock is often intertwined with purposeful bleakness and irony,the upbeat earnestness of The Pains of Being Pure at Heart is a breath of fresh air.Even so,the poppy sensibility of so many of their songs belies a dark and con-templative emotional core.
