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OBJECTIVE: To assess (1) pediatricians' attitudes toward and practice of complementary and alternative medicine (CAM) for their patients; (2) their knowledge, experience, and referral patterns for selected CAM therapies; and (3) their desire for continuing medical education courses on CAM therapies. METHOD: An anonymous, self-report, 25-item questionnaire was mailed to fellows of the Michigan chapter of the American Academy of Pediatrics. RESULTS: Of 860 pediatricians, 348 (40.5%) responded; their median age ranged from 35 to 45 years, 54.3% were men, 67.6% were white, 67.9% were general pediatricians, and 65.2% were trained in the United States. Of the respondents, 83.5% believed their patients use CAM therapies, but 55.1% believed this constituted less than 10% of patients. Of the pediatricians who talked about CAM (53.8%), 84.7% said the discussion was initiated generally by the patient's family. More than half of the physicians (55.2%) said they would use CAM therapies personally, and 50.3% would refer for CAM therapies. Therapies referred for were biofeedback (23.6%), self-help groups (23.3%), relaxation (14.9%), hypnosis (13.8%), and acupuncture or acupressure (10.9%). Of the physicians who responded, 54.1% were interested in continuing medical education courses on CAM therapies. White respondents, US medical school graduates, and general pediatricians were most likely to believe their patients use CAM and discuss or refer for CAM therapies (P<.01). Female pediatricians were most likely to discuss or refer for CAM and to want more continuing medical education on CAM therapies (P<.05). CONCLUSIONS: A majority of pediatricians sampled believed a small percentage of their patients were seeking alternatives to conventional medicine. Half would consider referring patients for CAM, and most were interested in continuing medical education courses on CAM. Larger studies surveying pediatricians, along with more education and research on CAM therapies, need to be considered for the future.  相似文献   
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We investigated experimentally the effects of a spatially non-uniform stretch rate on the flame temperature. A flame surface with a non-uniform stretch rate was formed by creating a wrinkled laminar premixed flame in a spatially periodic flow field of a lean propane/air mixture. The measured flame temperature was lower/higher than the adiabatic flame temperature at flame segments with positive/negative stretch rates. This was a result of the effects of flame stretch and preferential diffusion for Lewis number greater than unity. The flame temperature estimated using the conventional flame stretch theory, which is based on a uniform stretch rate along the flame surface, did not agree quantitatively with the measured temperature. Therefore, we revised the theory, taking into account heat transfer along the flame surface, and then produced estimates that agreed with the measured temperature. We found that the effect of flame stretch and preferential diffusion is changed along the flame surface which has spatially non-uniform stretch rate, causing a temperature gradient along the surface, which in turn transfers heat and changes the flame temperature. Thus, heat transfer along the flame surface is an important factor in estimating flame temperature. In addition, a second temperature gradient appears downstream just behind the flame, because the temperature of the burned gas is also non-uniform. Therefore, conductive heat transfer is believed to occur between the flame and the burned gas. The effect of the downstream heat transfer is not as large as that of the heat transfer along the flame surface.  相似文献   
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Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that shows progressive muscle weakness. A few treatments exist including symptomatic therapies, which can prolong survival or reduce a symptom; however, no fundamental therapies have been found. As a therapeutic strategy, enhancing muscle force is important for patients’ quality of life. In this study, we focused on skeletal muscle-specific myosin regulatory light chain kinase (skMLCK), which potentially enhances muscle contraction, as overexpression of skMLCK was thought to improve muscle function. The adeno-associated virus serotype 6 encoding skMLCK (AAV6/skMLCK) and eGFP (control) was produced and injected intramuscularly into the lower limbs of SOD1G37R mice, which are a familial ALS model. AAV6/skMLCK showed the successful expression of skMLCK in the muscle tissues. Although the control did not affect the muscle force in both of the WT and SOD1G37R mice, AAV6/skMLCK enhanced the twitch force of SOD1G37R mice and the tetanic force of WT and SOD1G37R mice. These results indicate that overexpression of skMLCK can enhance the tetanic force of healthy muscle as well as rescue weakened muscle function. In conclusion, the gene transfer of skMLCK has the potential to be a new therapy for ALS as well as for other neuromuscular diseases.  相似文献   
88.
The carbon support effect of Pt–Ni(mqph) electrocatalysts on the performance of CO tolerant anode catalysts for polymer electrolyte fuel cells (PEFCs) was investigated using carbon black and multi-walled carbon nanotubes (MWCNTs), with and without defect preparation. 20%Pt–Ni(mqph)/defect-free CNTs showed a very high CO tolerance (75% compared to the CO-free H2 case) under 100 ppm CO level in the half-cell system of the hydrogen oxidation reaction. On the other hand, the hydrogen oxidation current on Pt–Ni(mqph)/defective CNTs, Pt–Ni(mqph)/VulcanXC-72R and Pt–Ru/VulcanXC-72R significantly decreased with increasing concentration of CO up to 100 ppm (25–47% compared to the CO-free H2 case). It is thus considered that the carbon support materials strongly affect the CO tolerance of anode catalysts. This is ascribed to a change in the electronic structure of the Pt particles due to the interaction with the graphene surface, leading to a reduction in the adsorption energy of CO. Ni(mqph) also mitigates CO poisoning due to its ability of CO coordination on Ni metal center.  相似文献   
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In the present study, an attempt is made to understand the mechanism of field emission electron microscopy (FE-SEM) observation of wet agar gel using a typical hydrophilic ionic liquid (IL) 1-butyl-3-methylimidazolium tetrafluoroborate; [BMIM][BF4]. The IL interaction with water molecules within agar gel during sample preparation condition for FE-SEM observation was investigated using Raman spectroscopy. Results showed that water molecules within agar gel form weak hydrogen bond such as BF4?HOH?BF4 by interaction with BF4 of IL, and, it remained stable even under vacuum condition at 60 °C, 24 h. This interaction was found to be helpful for IL displacement of the water molecules within agar gel. From this study, it was found that the exact morphology of gel materials in FE-SEM condition can be observed by optimization of water concentrations of IL and gel mixtures. Thus, using IL, agar gel or any other material under wet condition can be observed without drying in FE-SEM chamber, and, present result gives an insight to the mechanism of FE-SEM observation of agar gel using IL without any conducting coating.  相似文献   
90.
The fluoride ion content in serum and in dialysate medium was determined by means of a fluoride ion-selective electrode in 29 patients undergoing hemodialysis treatment. Abnormally high serum fluoride of 65.9 +/- 28.3 microg l(-1) at the beginning and 46.5 +/- 26.7 microg l(-1) at the completion of the hemodialysis session was observed. Results showed that 60.0 +/- 23.9% of the serum fluoride at the beginning of the session was theoretically filterable, and 80.8 +/- 42.4% of this fraction was actually filtered throughout the hemodialysis session. The dialysis procedure is considered to be safe and adequate for serum fluoride removal. The high serum fluoride at the completion of the hemodialysis session was thought to originate from the fraction of unfilterable binding fluoride. To make further progress towards improvements in serum fluoride removal during HD, attention to the binding fraction of serum fluoride is required.  相似文献   
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