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31.
The effects of ovariectomy and estradiol replacement were determined in streptozotocin-diabetic female rats maintained on daily injections of protamine zinc insulin. Similar changes in food intake and body weight in these animals and in nondiabetic control animals indicate that the effects of estradiol on these measures are probably not dependent on changes in pancreatic insulin secretion. Acute and chronic insulin challenges in ovariectomized rats maintained on estradiol benzoate, nafoxidine or oil were also examined. The effects of insulin were not attenuated by prior estrogen conditioning, and there was no evidence of insulin resistance. These experiments suggest that the effects of estradiol on body weight and food intake in female rats are not dependent upon altered insulin levels nor attenuation of the effects of insulin. Estradiol may exert its influence on eating and body weight via separate and possibly more direct pathways. The data also are consistent with the suggestion that ovariectomy-induced and hypothalamic obesities are separate phenomena. 相似文献
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Gass Julie C. Funderburk Jennifer S. Wade Michael Acker John D. Maisto Stephen A. 《Zeitschrift fur Gesundheitswissenschaften》2022,30(3):771-780
Journal of Public Health - To determine whether statistically distinct classes of smokers exist according to mental health (MH) diagnoses within primary care and to evaluate whether class... 相似文献
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Distal rectus femoris surgery in children with cerebral palsy: results of a Delphi consensus project
Robert M. Kay Kristan Pierz James McCarthy H. Kerr Graham Henry Chambers Jon R. Davids Unni Narayanan Tom F. Novacheck Jason Rhodes Erich Rutz Jeffrey Shilt Benjamin J. Shore Matthew Veerkamp M. Wade Shrader Tim Theologis Anja Van Campenhout Thomas Dreher 《Journal of children's orthopaedics》2021,15(3):270
PurposeThe purpose of this study was for an international panel of experts to establish consensus indications for distal rectus femoris surgery in children with cerebral palsy (CP) using a modified Delphi method.MethodsThe panel used a five-level Likert scale to record agreement or disagreement with 33 statements regarding distal rectus femoris surgery. The panel responded to statements regarding general characteristics, clinical indications, computerized gait data, intraoperative techniques and outcome measures. Consensus was defined as at least 80% of responses being in the highest or lowest two of the five Likert ratings, and general agreement as 60% to 79% falling into the highest or lowest two ratings. There was no agreement if neither threshold was reached.ResultsConsensus or general agreement was reached for 17 of 33 statements (52%). There was general consensus that distal rectus femoris surgery is better for stiff knee gait than is proximal rectus femoris release. There was no consensus about whether the results of distal rectus femoris release were comparable to those following distal rectus femoris transfer. Gross Motor Function Classification System (GMFCS) level was an important factor for the panel, with the best outcomes expected in children functioning at GMFCS levels I and II. The panel also reached consensus that they do distal rectus femoris surgery less frequently than earlier in their careers, in large part reflecting the narrowing of indications for this surgery over the last decade.ConclusionThis study can help paediatric orthopaedic surgeons optimize decision-making for, and outcomes of, distal rectus femoris surgery in children with CP.Level of evidenceV 相似文献
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In this article, the authors simulate the effects on Federal and State Medicaid expenditures of increasing Medicaid fees to Medicare fee schedule (MFS) levels. Strict adoption of the MFS by the States would increase total Medicaid spending by approximately 4 percent, $2.5 to $2.9 billion. Because Medicaid fees vary across States, so does the impact of adopting the MFS. Medicaid spending would increase significantly in some wealthy States with large Medicaid populations and in a few small, relatively poor States. Some States currently pay more than the MFS for obstetrical services. If these fees continued at higher levels for obstetrical care, total Medicaid spending would increase by $3.5 to $4.0 billion. 相似文献
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This article reports a study of the process of selecting and evaluating general surgery residents. In personnel psychology terms, a job analysis of general surgery was conducted using the Critical Incident Technique (CIT). The researchers collected 235 critical incidents through structured interviews with 10 general surgery faculty members and four senior residents. The researchers then directed the surgeons in a two-step process of sorting the incidents into categories and naming the categories. The final essential categories of behavior to define surgical competence were derived through discussion among the surgeons until a consensus was formed. Those categories are knowledge/self-education, clinical performance, diagnostic skills, surgical skills, communication skills, reliability, integrity, compassion, organization skills, motivation, emotional control, and personal appearance. These categories were then used to develop an interview evaluation form for selection purposes and a performance evaluation form to be used throughout residency training. Thus a continuum of evaluation was established. The categories and critical incidents were also used to structure the interview process, which has demonstrated increased interview validity and reliability in many other studies. A handbook for structuring the interviews faculty members conduct with applicants was written, and an interview training session was held with the faculty. The process of implementation of the structured selection interviews is being documented currently through qualitative research. 相似文献
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