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Regional variation in routes to diagnosis of cholangiocarcinoma in England from 2006 to 2017
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作者 Amy Zalin-Miller Sophie Jose +5 位作者 Craig Knott Lizz Paley Daniela Tataru Helen Morement Mireille B Toledano Shahid A Khan 《World Journal of Gastroenterology》 SCIE CAS 2023年第24期3825-3842,共18页
BACKGROUND Incidence of cholangiocarcinoma(CCA)is rising,with overall prognosis remaining very poor.Reasons for the high mortality of CCA include its late presentation in most patients,when curative options are no lon... BACKGROUND Incidence of cholangiocarcinoma(CCA)is rising,with overall prognosis remaining very poor.Reasons for the high mortality of CCA include its late presentation in most patients,when curative options are no longer feasible,and poor response to systemic therapies for advanced disease.Late presentation presents a large barrier to improving outcomes and is often associated with diagnosis via mergency presentation(EP).Earlier diagnoses may be made by Two Week Wait(TWW)referrals through General practitioner(GP).We hypothesise that TWW referrals and EP routes to diagnosis differ across regions in England.AIM To investigate routes to diagnosis of CCA over time,regional variation and influencing factors.METHODS We linked patient records from the National Cancer Registration Dataset to Hospital Episode Statistics,Cancer Waiting Times and Cancer Screening Programme datasets to define routes to diagnosis and certain patient characteristics for patients diagnosed 2006-2017 in England.We used linear probability models to investigate geographic variation by assessing the proportions of patients diagnosed via TWW referral or EP across Cancer Alliances in England,adjusting for potential confounders.Correlation between the proportion of people diagnosed by TWW referral and EP was investigated with Spearman’s correlation coefficient.RESULTS Of 23632 patients diagnosed between 2006-2017 in England,the most common route to diagnosis was EP(49.6%).Non-TWW GP referrals accounted for 20.5%of diagnosis routes,13.8%were diagnosed by TWW referral,and the remainder 16.2%were diagnosed via an‘other’or Unknown route.The proportion diagnosed via a TWW referral doubled between 2006-2017 rising from 9.9%to 19.8%,conversely EP diagnosis route declined,falling from 51.3%to 46.0%.Statistically significant variation in both the TWW referral and EP proportions was found across Cancer Alliances.Age,presence of comorbidity and underlying liver disease were independently associated with both a lower proportion of patients diagnosed via TWW referral,and a higher proportion diagnosed by EP after adjusting for other potential confounders.CONCLUSION There is significant geographic and socio-demographic variation in routes to diagnosis of CCA in England.Knowledge sharing of best practice may improve diagnostic pathways and reduce unwarranted variation. 展开更多
关键词 CHOLANGIOCARCINOMA Route to diagnosis Two Week Wait Emergency presentation regional variation
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Regional variation of pediatric inflammatory bowel disease in Saudi Arabia: Results from a multicenter study 被引量:1
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作者 Mohammad I El Mouzan Mohammed H AlEdreesi +3 位作者 Mohammed Y Hasosah Abdulrahman A Al-Hussaini Ahmad A Al Sarkhy Asaad A Assiri 《World Journal of Gastroenterology》 SCIE CAS 2020年第4期416-423,共8页
BACKGROUND Incidence and severity variations of inflammatory bowel disease(IBD)have been reported from Western populations between continents and regions of the same countries.However,no data were available from other... BACKGROUND Incidence and severity variations of inflammatory bowel disease(IBD)have been reported from Western populations between continents and regions of the same countries.However,no data were available from other countries.AIM To investigate the regional differences in the IBD profiles of pediatric patients from the Kingdom of Saudi Arabia.METHODS Data from a national multicenter IBD study were used.The incidence,time trend,and clinical presentation of Crohn’s disease(CD)and ulcerative colitis(UC)in the Central region(CR),Western region(WR),and Eastern region(ER)were analyzed and compared.Statistical analysis included Poisson regression analysis for incidence variation and Chi-square test for demographic and clinical parameters.A P<0.05 was considered significant.RESULTS The prevalence of positive family history was lower in children with CD from the ER than the CR or the WR.Consanguinity rate was higher in children with CD and UC from the CR and the ER,respectively.The incidences and time trends of CD and UC were not significantly different between regions.In the ER,a significantly higher percentage of children with CD presented with abdominal pain(P<0.001),blood in stools(P=0.048),stricturing or penetrating disease(P=0.029),higher erythrocyte sedimentation rate(P<0.001),higher C-reactive protein(P<0.001),higher anemia(P=0.017),and lower albumin level(P=0.014).For children with UC from the ER,a significantly higher percentage presented with anemia(P=0.006)and a lower percentage with pancolitis(P<0.001).CONCLUSION The most important finding is the identification of significantly more severe presentation of CD in the ER of the Kingdom of Saudi Arabia.Prospective studies are needed to explain such variations. 展开更多
关键词 Crohn’s disease Ulcerative colitis EPIDEMIOLOGY CHILDREN regional variation
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Comment on “The diurnal variation pattern of choroidal thickness in macular region of young healthy female individuals using spectral domain optical coherence tomography”
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作者 Salih Uzun Emre Pehlivan Mehmet Gulmez 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2017年第11期1789-1790,共2页
Dear Editor,We have read and reviewed the article entitled'The diurnal variation pattern of choroidal thickness in macular region of young healthy female individuals using spectral domain optical coherence tomogra... Dear Editor,We have read and reviewed the article entitled'The diurnal variation pattern of choroidal thickness in macular region of young healthy female individuals using spectral domain optical coherence tomography'by Zhao et al^([1])with great interest.The authors evaluated the pattern of diurnal variations 展开更多
关键词 CT The diurnal variation pattern of choroidal thickness in macular region of young healthy female individuals using spectral domain optical coherence tomography cycle
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Influence of Geographical Regions on Catechin and Caffeine Levels in Tea (Camellia sinensis)
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作者 Augustine Mutuku John Wanyoko +5 位作者 Francis Wachira Samson Kamunya Richard Chalo Samuel Kimutai Kelvin Moseti Stephen Karori 《American Journal of Plant Sciences》 2016年第3期562-571,共10页
This study aimed at investigating the influence of different growing conditions in two regions, Timbilil and Kangaita, on the levels of catechins and caffeine. Fresh leaf samples of 60 clones cultivated in both sites ... This study aimed at investigating the influence of different growing conditions in two regions, Timbilil and Kangaita, on the levels of catechins and caffeine. Fresh leaf samples of 60 clones cultivated in both sites were obtained, processed and assayed for levels of caffeine, total and individual catechins using Reverse Phase High Performance Liquid Chromatography (RP-HPLC). The obtained data was subjected to analysis of variance using GENSTAT-C statistical software. Safe for a few clones in the Kangaita site had significantly higher total and individual catechins than those grown in the Timbilil site. A mean epigallocatechin gallate (EGCG) content of 7.9% was observed for Kangaita clones compared to 6.7% in Timbilil. A similar trend was observed for the rest of the individual catechin fractions with a mean epicatechin gallate (ECG) of 3.3% in Kangaita and 2.5% in Timbilil, a mean epigallocatechin (EGC) of 5.2% in Kangaita compared to 5.0% in Timbilil and a mean epicatechin (EC) content of 1.5% in Kangaita compared to 1.4% in Timbilil. Similarly in the total catechins analyses, clones in Kangaita had a mean value of 18.7% compared to 16.2% observed for the Timbilil site clones. However, the Timbilil site clones had significantly high caffeine contents (mean, 4.2%) compared to the Kangaita site clones (mean, 3.9%) although with a few exceptions. Significant interactions (P < 0.05) between clone and region are also observed, suggesting that levels of these biomolecules are bound to differ with the growing region but the extent of variation will vary depending on the clonal genotype. The observed differences in levels of these biologically important biomolecules among the two regions shows the importance of the underlying conditions on the production of tea. 展开更多
关键词 Camellia sinensis Clonal variations regional variations CATECHINS CAFFEINE
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Dynamic change of desertified land in each county around Qinghai Lake in recent 30 years
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作者 TIAN Li-hui ZHANG Deng-shan +3 位作者 HU Meng-jun LU Rui-jie ZHAO Chao WU Wang-yang 《地球环境学报》 2012年第6期1134-1143,共10页
Desertification is one of the most serious eco-environmental problems around Qinghai Lake.Based on GIS and RS,GIS analysis was used to obtain the information of spatial-temporal change and different pattern of deserti... Desertification is one of the most serious eco-environmental problems around Qinghai Lake.Based on GIS and RS,GIS analysis was used to obtain the information of spatial-temporal change and different pattern of desertification in each county around Qinghai Lake in four phases of1976,1987,1995 and 2006.Using the function of intersect and overlay supported by ARCGIS,with analyzing attributes of vector RS images,we obtained transition data and established transfer matrix of land-use types in recent 30 years,besides,protracted land-use transition maps of all desertification classes.In further,we analyzed transition quantity and direction of desertification in each county,moreover,reconstructed the process of spatial-temporal evolution of desertification.The results are showed below:(1)it's the transition between desertified land and others but not in the desertified that played the main role in Gangcha and Gonghe County,while the transfer between desertified lands were greater than that with other land-use types in Haiyan County.(2)Extremely severe desertified land mainly distributes in Ketu and Sand Islands that belongs to Haiyan County,and moderate desertified land in riversides of Gangcha County,also,the light desertification expanded too rapidly to become the most desertified land-use type in the surrounding of Qinghai Lake since 1976.(3)By using relative change rate of desertified land,the regional variability rank from top to toe was Gangcha,Haiyan and Gonghe. 展开更多
关键词 The area around Qinghai Lake desertified land transition of land-use types spatial change regional variation
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Strong variation in frequencies of male and female determiners between neighboring housefly populations
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作者 Xuan Li Fangfei Lin +1 位作者 Louis van de Zande Leo W.Beukeboom 《Insect Science》 SCIE CAS CSCD 2022年第5期1470-1482,共13页
Sex-determination mechanisms evolve rapidly and vary between species.Occasionally,polymorphic systems are found,like in the housefly.Studying the dynamics and stability of such systems can provide a better understandi... Sex-determination mechanisms evolve rapidly and vary between species.Occasionally,polymorphic systems are found,like in the housefly.Studying the dynamics and stability of such systems can provide a better understanding of the evolution of sex-determination systems.In the housefly,dominant male-determining loci(M)can lie not only on the Y chromosome(M^(Y)),but also on autosomes(M^(A))or the X chromosome(M^(X)).M enforces male development by inhibiting the female-determining gene transformer(tra).A mutant tra allele,tra^(D),is insensitive to M and is a dominant female determiner.M^(Y) prevails at high latitudes and polymorphic M loci together with tra^(D) at low latitudes.To get more insight into the stability and frequencies of these sex determiners with mutually exclusive dominance,we investigated 5 regional Spanish populations.We found strong variation among populations.Two populations with hemizygous M^(III) were found,2 contained homozygous M^(X) with additional hemizygous MI and M^(II) in 1 population.One population contained homozygous and hemizygous M^(X) with additionally hemizygous M^(II).All females in populations with homozygous M,had tra^(D),whereas no tra^(D) was found in populations without homozygous M.Our results indicate locally stable systems may either harbor a single hemizygous M and no tra^(D),corresponding to a male heterogametic system,or homozygous and/or multiple M and heterozygous tra^(D),reminiscent of a female heterogametic system.They support that M loci can accumulate in the presence of a dominant female determiner.Limited migration between populations may contribute to the stability of these systems. 展开更多
关键词 ANEUPLOIDY HOUSEFLY polymorphic sex determination recombination regional variation sex-determining loci
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Bearing Fault Numerical Model for the Closed-slot Rotor Submersible Motor
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作者 Zhe Ke Bokai Guan +2 位作者 Chong Di Jingwen Yan Xiaohua Bao 《Chinese Journal of Electrical Engineering》 CSCD 2023年第2期84-93,共10页
A numerical model of the bearing fault of a motor with a closed-slot rotor using the finite element method(FEM)is proposed.The rotor’s radial motion can be regarded as static eccentric at the defect time points and h... A numerical model of the bearing fault of a motor with a closed-slot rotor using the finite element method(FEM)is proposed.The rotor’s radial motion can be regarded as static eccentric at the defect time points and healthy at other time points.The frequency of the harmonic component is analyzed corresponding to bearing fault in stator current according to the radial movement of the motor shaft.Moreover,the relative permeability variation region is established to achieve the radial motion of the rotor with bearing fault.Firstly,the relative permeability variation region is established in the health and static eccentric models.Then,the defect time points are estimated and the static eccentricity model by transient field is analyzed.Finally,the relative permeability of the variable region in the static eccentric model is imported into the variable region of the health model at the defect time points.The simulation results show that the air gap flux density of the bearing fault model is different from that of the health model and static eccentric models.In addition,the stator current contains harmonic components of the bearing fault.The analysis results prove the applicability of the proposed model. 展开更多
关键词 Bearing fault finite element method relative permeability variation region closed-slot rotor stator current
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基于洪水行为聚类的淮河流域洪水事件时空演变特征探讨 被引量:7
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作者 张永勇 陈秋潭 夏军 《Journal of Geographical Sciences》 SCIE CSCD 2020年第12期2053-2075,共23页
Flood is one of the severest natural disasters in the world and has caused enormous causalities and property losses.Previous studies usually focus on flood magnitude and occurrence time at event scale,which are insuff... Flood is one of the severest natural disasters in the world and has caused enormous causalities and property losses.Previous studies usually focus on flood magnitude and occurrence time at event scale,which are insufficient to contain entire behavior characteristics of flood events.In our study,nine behavior metrics in five categories(e.g.,magnitude,duration,timing,rates of changes and variability)are adopted to fully describe a flood event.Regional and interannual variations of representative flood classes are investigated based on behavior similarity classification of numerous events.Contributions of geography,land use,hydrometeorology and human regulation on these variations are explored by rank analysis method.Results show that:five representative classes are identified,namely,conventional events(Class 1,61.7% of the total),low discharge events with multiple peaks(Class 2,5.3%),low discharge events with low rates of changes(Class 3,18.1%),low discharge events with high rates of changes(Class 4,10.8%)and high discharge events with long durations(Class 5,4.1%).Classes 1 and 3 are the major flood events and distributed across the whole region.Class 4 is mainly distributed in river sources,while Classes 2 and 5 are in the middle and down streams.Moreover,the flood class is most diverse in normal precipitation years(2006,2008-2010 and 2015),followed by wet years(2007,2013-2014),and dry years(2011 and 2012).All the impact factor categories explain 34.0%-84.1% of individual flood class variations.The hydrometeorological category(7.2%-56.9%)is the most important,followed by geographical(1.0%-6.3%),regulation(1.7%-5.1%)and land use(0.9%-2.2%)categories.This study could provide new insights into flood event variations in a comprehensive manner,and provide decision-making basis for flood control and resource utilization at basin scale. 展开更多
关键词 flood events behavior metrics CLASSIFICATION regional and interannual variations potential impacts
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