Objective To examine general practitioners’(GPs)referral patterns to allied health services for people with dementia compared with those without dementia across two large Australian Primary Health Networks(PHNs).Desi...Objective To examine general practitioners’(GPs)referral patterns to allied health services for people with dementia compared with those without dementia across two large Australian Primary Health Networks(PHNs).Design A retrospective cohort study using routinely collected general practice data.Logistic regression was used to compare odds of allied health referrals,adjusting for age,sex and socioeconomic status.Setting De-identified patient and episode activity data from 537 GP practices across two PHNs in Australia between 2018 and 2023.Participants Data from 1153304 patients and 28667517 GP episodes of care were analysed.After merging records,693328 unique patients were identified,including 16610 patients with dementia.Subcohorts included patients with dementia,stroke,Parkinson’s disease and combinations of these conditions.Results The dementia cohort(n=16610)had a similar overall allied health referral rate(36.1%)to the control cohort(n=48977)(35.4%).Patients with dementia only were significantly less likely to receive any allied health referral compared with those with stroke(adjusted OR(aOR)0.76,95%CI 0.72 to 0.80;p<0.001)or Parkinson’s disease(aOR 0.72,95%CI 0.66 to 0.78;p<0.001).Those with dementia and stroke were also less likely to receive referrals than those with stroke only(aOR 0.71,95%CI 0.61 to 0.82;p<0.001).No significant difference was found between dementia with Parkinson’s and Parkinson’s only groups(p=0.48).Patients with dementia were consistently less likely to be referred to key allied health services(p<0.05).Conclusion Despite strong evidence supporting allied health interventions for dementia,referral rates remain comparatively low.Enhancing GP referral resources and education,integrating dementia-specific care pathways and implementing supportive policy changes are needed to improve access and equity in dementia care.展开更多
Osteocytes reside as three-dimensionally（3D） networked cells in the lacunocanalicular structure of bones and regulate bone and mineral homeostasis. Despite of their important regulatory roles, in vitro studies of os...Osteocytes reside as three-dimensionally（3D） networked cells in the lacunocanalicular structure of bones and regulate bone and mineral homeostasis. Despite of their important regulatory roles, in vitro studies of osteocytes have been challenging because：（1） current cell lines do not sufficiently represent the phenotypic features of mature osteocytes and（2） primary cells rapidly differentiate to osteoblasts upon isolation. In this study, we used a 3D perfusion culture approach to：（1） construct the 3D cellular network of primary murine osteocytes by biomimetic assembly with microbeads and（2） reproduce ex vivo the phenotype of primary murine osteocytes, for the first time to our best knowledge. In order to enable 3D construction with a sufficient number of viable cells, we used a proliferated osteoblastic population of healthy cells outgrown from digested bone chips. The diameter of microbeads was controlled to：（1） distribute and entrap cells within the interstitial spaces between the microbeads and（2） maintain average cell-to-cell distance to be about 19 mm. The entrapped cells formed a 3D cellular network by extending and connecting their processes through openings between the microbeads. Also, with increasing culture time, the entrapped cells exhibited the characteristic gene expressions（SOST and FGF23） and nonproliferative behavior of mature osteocytes. In contrast, 2D-cultured cells continued their osteoblastic differentiation and proliferation. This 3D biomimetic approach is expected to provide a new means of：（1） studying flow-induced shear stress on the mechanotransduction function of primary osteocytes,（2） studying physiological functions of 3D-networked osteocytes with in vitro convenience,and（3） developing clinically relevant human bone disease models.展开更多
Focusing on the peculiarities of urban construction resulting from specific mountain terrains, the purpose of this study is to find out a suitable method based on a Spatial Network Comprehensive Model(SNCM) to reasona...Focusing on the peculiarities of urban construction resulting from specific mountain terrains, the purpose of this study is to find out a suitable method based on a Spatial Network Comprehensive Model(SNCM) to reasonably plan and distribute primary schools in low-income mountain cities. The construction principles and advantages of the SNCM method are proposed and the method tested in Wanyuan city of Qinba Mountain area(Southwest China) to verify its feasibility and optimization. Taking account of the mountain terrain and its influence on user behavior, we used the SNCM method to build a comprehensive model which integrates the road slope and the walking speed of pupils into the basic spatial model. The model is used to calculate a reasonable layout of the primary schools and to validate the rationale. The results show that the SNCM method can be effectively applied in low-income mountainous cities. It can not only improve the accessibility and service efficiency of primary schools using as little capital-investment as possible, but also help the city grow in an intensive and efficient way.展开更多
This research presents the variation of the gravity field and associated gravity field components over the continental area of Nigeria to provide data for geoscience research,geodetic and engineering works,aerodynamic...This research presents the variation of the gravity field and associated gravity field components over the continental area of Nigeria to provide data for geoscience research,geodetic and engineering works,aerodynamic studies and deep crustal inferences.Accurate positions and elevations were observed at 58 of the 59 base stations of the Primary Gravity Network of Nigeria(PGNN),whose absolute gravity values had been accurately determined.The absolute gravity values were plotted against their respective positions to reveal the distribution pattern and strength of the gravity field within the study area.Theoretical gravity values at each base station were generated using the Somigliana's equation.The free-air gravity and free-air anomaly gravity values were generated with respect to the World Geodetic System 1984(WGS84)ellipsoid using GPS-derived elevation data.Then,the perturbing potential,free-air gravity with respect to the geoid,and the indirect effects were evaluated.The average of the indirect effects was used to adjust the WGS84 gravity formula to produce a gravity formula that better approximates the geoid across the continental area of Nigeria,compatible with the heights measured relative to the geoid,which can serve as a reference for establishing a vertical height control.The Bouguer gravity and Bouguer gravity anomalies across Nigeria revealed a“trans-southern gravity high strip”interpreted to be associated with mantle upwelling.Two new major mega-lineaments related to mantle upwelling were mapped.A batholith province trending NWeSE was delineated,occurring from north central Nigeria to the north western region and containing closures of“Bouguer gravity lows”interpreted as batholiths.A separate closure of“Bouguer gravity low”was detected at Azare,north eastern Nigeria,which may be due to the presence of intrusive granitic body.It is recommended that the mantle structure beneath“the trans-southern gravity high strip”,“delineated batholith province”and“isolated gravity closures”around the northeast of Nigeria should be studied from seismic shear wave splitting analysis for better understanding of the deep lithospheric structures and moho relief.展开更多
基金funded by the Australian Government Medical Research Future Fund(MRFF),Grant number 2015947.
文摘Objective To examine general practitioners’(GPs)referral patterns to allied health services for people with dementia compared with those without dementia across two large Australian Primary Health Networks(PHNs).Design A retrospective cohort study using routinely collected general practice data.Logistic regression was used to compare odds of allied health referrals,adjusting for age,sex and socioeconomic status.Setting De-identified patient and episode activity data from 537 GP practices across two PHNs in Australia between 2018 and 2023.Participants Data from 1153304 patients and 28667517 GP episodes of care were analysed.After merging records,693328 unique patients were identified,including 16610 patients with dementia.Subcohorts included patients with dementia,stroke,Parkinson’s disease and combinations of these conditions.Results The dementia cohort(n=16610)had a similar overall allied health referral rate(36.1%)to the control cohort(n=48977)(35.4%).Patients with dementia only were significantly less likely to receive any allied health referral compared with those with stroke(adjusted OR(aOR)0.76,95%CI 0.72 to 0.80;p<0.001)or Parkinson’s disease(aOR 0.72,95%CI 0.66 to 0.78;p<0.001).Those with dementia and stroke were also less likely to receive referrals than those with stroke only(aOR 0.71,95%CI 0.61 to 0.82;p<0.001).No significant difference was found between dementia with Parkinson’s and Parkinson’s only groups(p=0.48).Patients with dementia were consistently less likely to be referred to key allied health services(p<0.05).Conclusion Despite strong evidence supporting allied health interventions for dementia,referral rates remain comparatively low.Enhancing GP referral resources and education,integrating dementia-specific care pathways and implementing supportive policy changes are needed to improve access and equity in dementia care.
基金the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health (1R21AR065032 to W.Y.L and J.Z.)the National Science Foundation (DMR 1409779 to W.Y.L and J.Z.)
文摘Osteocytes reside as three-dimensionally（3D） networked cells in the lacunocanalicular structure of bones and regulate bone and mineral homeostasis. Despite of their important regulatory roles, in vitro studies of osteocytes have been challenging because：（1） current cell lines do not sufficiently represent the phenotypic features of mature osteocytes and（2） primary cells rapidly differentiate to osteoblasts upon isolation. In this study, we used a 3D perfusion culture approach to：（1） construct the 3D cellular network of primary murine osteocytes by biomimetic assembly with microbeads and（2） reproduce ex vivo the phenotype of primary murine osteocytes, for the first time to our best knowledge. In order to enable 3D construction with a sufficient number of viable cells, we used a proliferated osteoblastic population of healthy cells outgrown from digested bone chips. The diameter of microbeads was controlled to：（1） distribute and entrap cells within the interstitial spaces between the microbeads and（2） maintain average cell-to-cell distance to be about 19 mm. The entrapped cells formed a 3D cellular network by extending and connecting their processes through openings between the microbeads. Also, with increasing culture time, the entrapped cells exhibited the characteristic gene expressions（SOST and FGF23） and nonproliferative behavior of mature osteocytes. In contrast, 2D-cultured cells continued their osteoblastic differentiation and proliferation. This 3D biomimetic approach is expected to provide a new means of：（1） studying flow-induced shear stress on the mechanotransduction function of primary osteocytes,（2） studying physiological functions of 3D-networked osteocytes with in vitro convenience,and（3） developing clinically relevant human bone disease models.
基金funded by the National Social Science Foundation of Chongqing (Grants No. 2016YBJJ031)
文摘Focusing on the peculiarities of urban construction resulting from specific mountain terrains, the purpose of this study is to find out a suitable method based on a Spatial Network Comprehensive Model(SNCM) to reasonably plan and distribute primary schools in low-income mountain cities. The construction principles and advantages of the SNCM method are proposed and the method tested in Wanyuan city of Qinba Mountain area(Southwest China) to verify its feasibility and optimization. Taking account of the mountain terrain and its influence on user behavior, we used the SNCM method to build a comprehensive model which integrates the road slope and the walking speed of pupils into the basic spatial model. The model is used to calculate a reasonable layout of the primary schools and to validate the rationale. The results show that the SNCM method can be effectively applied in low-income mountainous cities. It can not only improve the accessibility and service efficiency of primary schools using as little capital-investment as possible, but also help the city grow in an intensive and efficient way.
文摘This research presents the variation of the gravity field and associated gravity field components over the continental area of Nigeria to provide data for geoscience research,geodetic and engineering works,aerodynamic studies and deep crustal inferences.Accurate positions and elevations were observed at 58 of the 59 base stations of the Primary Gravity Network of Nigeria(PGNN),whose absolute gravity values had been accurately determined.The absolute gravity values were plotted against their respective positions to reveal the distribution pattern and strength of the gravity field within the study area.Theoretical gravity values at each base station were generated using the Somigliana's equation.The free-air gravity and free-air anomaly gravity values were generated with respect to the World Geodetic System 1984(WGS84)ellipsoid using GPS-derived elevation data.Then,the perturbing potential,free-air gravity with respect to the geoid,and the indirect effects were evaluated.The average of the indirect effects was used to adjust the WGS84 gravity formula to produce a gravity formula that better approximates the geoid across the continental area of Nigeria,compatible with the heights measured relative to the geoid,which can serve as a reference for establishing a vertical height control.The Bouguer gravity and Bouguer gravity anomalies across Nigeria revealed a“trans-southern gravity high strip”interpreted to be associated with mantle upwelling.Two new major mega-lineaments related to mantle upwelling were mapped.A batholith province trending NWeSE was delineated,occurring from north central Nigeria to the north western region and containing closures of“Bouguer gravity lows”interpreted as batholiths.A separate closure of“Bouguer gravity low”was detected at Azare,north eastern Nigeria,which may be due to the presence of intrusive granitic body.It is recommended that the mantle structure beneath“the trans-southern gravity high strip”,“delineated batholith province”and“isolated gravity closures”around the northeast of Nigeria should be studied from seismic shear wave splitting analysis for better understanding of the deep lithospheric structures and moho relief.
