Acute upper gastrointestinal bleeding(UGIB) is a gastroenterological emergency with a mortality of 6%-13%.The vast majority of these bleeds are due to peptic ulcers.Nonsteroidal anti-inflammatory drugs and Helicobacte...Acute upper gastrointestinal bleeding(UGIB) is a gastroenterological emergency with a mortality of 6%-13%.The vast majority of these bleeds are due to peptic ulcers.Nonsteroidal anti-inflammatory drugs and Helicobacter pylori are the main risk factors for peptic ulcer disease.Endoscopy has become the mainstay for diagnosis and treatment of acute UGIB,and is recommended within 24 h of presentation.Proton pump inhibitor(PPI) administration before endoscopy can downstage the bleeding lesion and reduce the need for endoscopic therapy,but has no effect on rebleeding,mortality and need for surgery.Endoscopic therapy should be undertaken for ulcers with high-risk stigmata,to reduce the risk of rebleeding.This can be done with a variety of modalities.High-dose PPI administration after endoscopy can prevent rebleeding and reduce the need for further intervention and mortality,particularly in patients with high-risk stigmata.展开更多
The purpose of this study is to explore how business organizations could effectively promote positive environmental norms among a larger section of the community. This study hypothesized that the development of a feel...The purpose of this study is to explore how business organizations could effectively promote positive environmental norms among a larger section of the community. This study hypothesized that the development of a feeling of high involvement among employees of organizations implementing the Environmental Management System （EMS） could result in the spillover phenomena of other environmentally responsible behavior in different domains such as, consumer preferences for environment-friendly products. The study also confirms the effects of environmental attitude （EA） and concrete knowledge （CK） as a mediator; acting not only as an axis to the spillover phenomenon but is also found to be the crucial factor in determining the strength of the whole spillover process.展开更多
Florida, along with Hawaii, has among the two worst invasive species problems in the USA, and the state is espe-cially susceptible to establishment by alien reptiles. Besides the large numbers of established non-nativ...Florida, along with Hawaii, has among the two worst invasive species problems in the USA, and the state is espe-cially susceptible to establishment by alien reptiles. Besides the large numbers of established non-native reptile species in Florida, many of these species present novel difficulties for management, or have other characteristics making effective management ex-tremely challenging. Moreover, initiation of management action requires more than recognition by experts that a potentially harmful species has become established. It also requires the political will along with concomitant resources and appropriate per-sonnel to develop effective methods and apply them. We review the situation in Florida, including assessment of risk for estab- lishment, and we use a subset of prominent species to illustrate in more detail the array of invasive reptile species circumstances in Florida, including routes of introduction, impacts, and potential and implemented management actions. These examples not only highlight the severity of the invasive reptile problems in the state, but they also show the diversity in resolve and response towards them and the motivating factors [Current Zoology 57 （5）： 599-612, 2011].展开更多
文摘Acute upper gastrointestinal bleeding(UGIB) is a gastroenterological emergency with a mortality of 6%-13%.The vast majority of these bleeds are due to peptic ulcers.Nonsteroidal anti-inflammatory drugs and Helicobacter pylori are the main risk factors for peptic ulcer disease.Endoscopy has become the mainstay for diagnosis and treatment of acute UGIB,and is recommended within 24 h of presentation.Proton pump inhibitor(PPI) administration before endoscopy can downstage the bleeding lesion and reduce the need for endoscopic therapy,but has no effect on rebleeding,mortality and need for surgery.Endoscopic therapy should be undertaken for ulcers with high-risk stigmata,to reduce the risk of rebleeding.This can be done with a variety of modalities.High-dose PPI administration after endoscopy can prevent rebleeding and reduce the need for further intervention and mortality,particularly in patients with high-risk stigmata.
文摘The purpose of this study is to explore how business organizations could effectively promote positive environmental norms among a larger section of the community. This study hypothesized that the development of a feeling of high involvement among employees of organizations implementing the Environmental Management System （EMS） could result in the spillover phenomena of other environmentally responsible behavior in different domains such as, consumer preferences for environment-friendly products. The study also confirms the effects of environmental attitude （EA） and concrete knowledge （CK） as a mediator; acting not only as an axis to the spillover phenomenon but is also found to be the crucial factor in determining the strength of the whole spillover process.
文摘Florida, along with Hawaii, has among the two worst invasive species problems in the USA, and the state is espe-cially susceptible to establishment by alien reptiles. Besides the large numbers of established non-native reptile species in Florida, many of these species present novel difficulties for management, or have other characteristics making effective management ex-tremely challenging. Moreover, initiation of management action requires more than recognition by experts that a potentially harmful species has become established. It also requires the political will along with concomitant resources and appropriate per-sonnel to develop effective methods and apply them. We review the situation in Florida, including assessment of risk for estab- lishment, and we use a subset of prominent species to illustrate in more detail the array of invasive reptile species circumstances in Florida, including routes of introduction, impacts, and potential and implemented management actions. These examples not only highlight the severity of the invasive reptile problems in the state, but they also show the diversity in resolve and response towards them and the motivating factors [Current Zoology 57 （5）： 599-612, 2011].
