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1.
Sci Total Environ ; 946: 174197, 2024 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-38914336

RESUMO

The 2022 wildfires in New Mexico, United States, were unparalleled compared to past wildfires in the state in both their scale and intensity, resulting in poor air quality and a catastrophic loss of habitat and livelihood. Among all wildfires in New Mexico in 2022, six wildfires were selected for our study based on the size of the burn area and their proximity to populated areas. These fires accounted for approximately 90 % of the total burn area in New Mexico in 2022. We used a regional chemical transport model and data-fusion technique to quantify the contribution of these six wildfires (April 6 to August 22) on particulate matter (PM2.5: diameter ≤ 2.5 µm) and ozone (O3) concentrations, as well as the associated health impacts from short-term exposure. We estimated that these six wildfires emitted 152 thousand tons of PM2.5 and 287 thousand tons of volatile organic compounds to the atmosphere. We estimated that the average daily wildfire smoke PM2.5 across New Mexico was 0.3 µg/m3, though 1 h maximum exceeded 120 µg/m3 near Santa Fe. Average wildfire smoke maximum daily average 8-h O3 (MDA8-O3) contribution was 0.2 ppb during the study period over New Mexico. However, over the state 1 h maximum smoke O3 exceeded 60 ppb in some locations near Santa Fe. Estimated all-cause excess mortality attributable to short term exposure to wildfire PM2.5 and MDA8-O3 from these six wildfires were 18 (95 % Confidence Interval (CI), 15-21) and 4 (95 % CI: 3-6) deaths. Additionally, we estimate that wildfire PM2.5 was responsible for 171 (95 %: 124-217) excess cases of asthma emergency department visits. Our findings underscore the impact of wildfires on air quality and human health risks, which are anticipated to intensify with global warming, even as local anthropogenic emissions decline.

2.
J Hazard Mater ; 474: 134794, 2024 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-38850929

RESUMO

As lithium metal resource supply and demand stabilize and prices decrease, the efficient recovery of valuable metals other than lithium from spent lithium-ion batteries is receiving increasing attention. Currently, challenges remain in the selective lithium recovery efficiency and the high cost of regenerating valuable metal slag after lithium extraction, particularly for spent ternary cathode materials. To address these challenges, this study introduces a closed-loop recovery process for spent ternary cathode materials, employing sulfur-assisted roasting to achieve efficient lithium extraction and high-value direct regeneration of ternary leaching residues. At moderate temperatures (500 â„ƒ), LiNixCoyMn1-x-yO2 (NCM) materials undergo a directional transformation of lithium to Li2SO4 in synergy with sulfur and oxygen, achieving a lithium leaching extraction rate of 98.91 %. Additionally, the relatively mild reaction conditions preserve the secondary spherical morphology and uniform distribution of NiCoMn-based oxide residue without introducing adverse impurities, ensuring the successful regeneration of high-value NCM cathode materials (R-NCM). The R-NCM material exhibits good discharge capacity (144.3 mA·h/g at 1 C) and relatively stable cycling performance, with a capacity retention rate of 80 % after 150 cycles. This work provides a viable pathway for the efficient and environmental-friendly pyrometallurgical closed-loop recovery of spent lithium-ion batteries.

3.
Environ Sci Technol ; 58(28): 12343-12355, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-38943591

RESUMO

Smoke from wildfires poses a substantial threat to health in communities near and far. To mitigate the extent and potential damage of wildfires, prescribed burning techniques are commonly employed as land management tools; however, they introduce their own smoke-related risks. This study investigates the impact of prescribed fires on daily average PM2.5 and maximum daily 8-h averaged O3 (MDA8-O3) concentrations and estimates premature deaths associated with short-term exposure to prescribed fire PM2.5 and MDA8-O3 in Georgia and surrounding areas of the Southeastern US from 2015 to 2020. Our findings indicate that over the study domain, prescribed fire contributes to average daily PM2.5 by 0.94 ± 1.45 µg/m3 (mean ± standard deviation), accounting for 14.0% of year-round ambient PM2.5. Higher average daily contributions were predicted during the extensive burning season (January-April): 1.43 ± 1.97 µg/m3 (20.0% of ambient PM2.5). Additionally, prescribed burning is also responsible for an annual average increase of 0.36 ± 0.61 ppb in MDA8-O3 (approximately 0.8% of ambient MDA8-O3) and 1.3% (0.62 ± 0.88 ppb) during the extensive burning season. We estimate that short-term exposure to prescribed fire PM2.5 and MDA8-O3 could have caused 2665 (95% confidence interval (CI): 2249-3080) and 233 (95% CI: 148-317) excess deaths, respectively. These results suggest that smoke from prescribed burns increases the mortality. However, refraining from such burns may escalate the risk of wildfires; therefore, the trade-offs between the health impacts of wildfires and prescribed fires, including morbidity, need to be taken into consideration in future studies.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Incêndios , Material Particulado , Georgia , Humanos , Mortalidade Prematura , Incêndios Florestais , Fumaça
4.
J Phys Chem Lett ; 15(20): 5359-5365, 2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38728665

RESUMO

Lithium ruthenium oxide (Li2RuO3) is an archetypal lithium rich cathode material (LRCM) with both cation and anion redox reactions (ARRs). Commonly, the instability of oxygen redox activities has been regarded as the root cause of its performance degradation in long-term operation. However, we find that not triggering ARRs does not improve and even worsens its cyclability due to the detrimental strain accumulation induced by Ru redox activities. To solve this problem, we demonstrate that F-doping in Li2RuO3 can alter its preferential orientation and buffer interlayer repulsion upon Ru redox, both of which can mitigate the strain accumulation along the c-axis and improve its structural stability. This work highlights the importance of optimizing cation redox reactions in LRCMs and provides a new perspective for their rational design.

5.
Exp Ther Med ; 25(5): 199, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37090075

RESUMO

Functional constipation (FC), a common symptom that is primarily associated with intestinal motility dysfunction, is a common problem worldwide. Arctiin (Arc) is a lignan glycoside isolated from the Chinese herbal medicine Arctium lappa L., which is a health food in China. The present study aimed to evaluate the laxative effects of Arc against FC in mice. A model of FC induced by loperamide (5 mg/kg) was established in male Institute of Cancer Research (ICR) mice. Arc was administered at a dose of 100 mg/kg as a protective agent. The faecal status, intestinal motility and histological analyses were evaluated. Furthermore, the levels of gastrointestinal motility-associated neurotransmitters, such as motilin (MTL), nitric oxide (NO), and brain-derived neurotrophic factor (BDNF) and the protective effect of Arc on interstitial cells of Cajal (ICC) were assessed. Arc treatment reversed the loperamide-induced reduction in faecal number and water content and the intestinal transit ratio in ICR mice. Histological analysis confirmed that Arc administration mitigated colonic injury. Moreover, Arc treatment increased levels of motilin and brain-derived neurotrophic factor while decreasing nitric oxide levels and ICC injury in the colon of FC mice. Arc decreased inflammation induction and aquaporin expression levels. Owing to its pro-intestinal motility property, Arc was shown to have a protective effect against FC and may thus serve as a promising therapeutic strategy for the management of FC.

6.
Braz J Med Biol Res ; 56: e12466, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36722660

RESUMO

Functional constipation (FC) is one of the most common gastrointestinal disorders characterized by hard stools and infrequent bowel movements, which is associated with dysfunction of the enteric nervous system and intestinal motility. Luteolin, a naturally occurring flavone, was reported to possess potential pharmacological activities on intestinal inflammation and nerve injury. This study aimed to explore the role of luteolin and its functional mechanism in loperamide-induced FC mice. Our results showed that luteolin treatment reversed the reduction in defecation frequency, fecal water content, and intestinal transit ratio, and the elevation in transit time of FC models. Consistently, luteolin increased the thickness of the muscular layer and lessened colonic histopathological injury induced by loperamide. Furthermore, we revealed that luteolin treatment increased the expression of neuronal protein HuC/D and the levels of intestinal motility-related biomarkers, including substance P (SP), vasoactive intestinal polypeptide (VIP), and acetylcholine (ACh), as well as interstitial cells of Cajal (ICC) biomarker KIT proto-oncogene, receptor tyrosine kinase (C-Kit), and anoctamin-1 (ANO1), implying that luteolin mediated enhancement of colonic function and contributed to the anti-intestinal dysmotility against loperamide-induced FC. Additionally, luteolin decreased the upregulation of aquaporin (AQP)-3, AQP-4, and AQP-8 in the colon of FC mice. In summary, our data showed that luteolin might be an attractive option for developing FC-relieving medications.


Assuntos
Constipação Intestinal , Loperamida , Luteolina , Animais , Camundongos , Acetilcolina , Colo , Constipação Intestinal/induzido quimicamente , Constipação Intestinal/tratamento farmacológico , Luteolina/farmacologia , Luteolina/uso terapêutico
7.
Braz. j. med. biol. res ; 56: e12466, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1420759

RESUMO

Functional constipation (FC) is one of the most common gastrointestinal disorders characterized by hard stools and infrequent bowel movements, which is associated with dysfunction of the enteric nervous system and intestinal motility. Luteolin, a naturally occurring flavone, was reported to possess potential pharmacological activities on intestinal inflammation and nerve injury. This study aimed to explore the role of luteolin and its functional mechanism in loperamide-induced FC mice. Our results showed that luteolin treatment reversed the reduction in defecation frequency, fecal water content, and intestinal transit ratio, and the elevation in transit time of FC models. Consistently, luteolin increased the thickness of the muscular layer and lessened colonic histopathological injury induced by loperamide. Furthermore, we revealed that luteolin treatment increased the expression of neuronal protein HuC/D and the levels of intestinal motility-related biomarkers, including substance P (SP), vasoactive intestinal polypeptide (VIP), and acetylcholine (ACh), as well as interstitial cells of Cajal (ICC) biomarker KIT proto-oncogene, receptor tyrosine kinase (C-Kit), and anoctamin-1 (ANO1), implying that luteolin mediated enhancement of colonic function and contributed to the anti-intestinal dysmotility against loperamide-induced FC. Additionally, luteolin decreased the upregulation of aquaporin (AQP)-3, AQP-4, and AQP-8 in the colon of FC mice. In summary, our data showed that luteolin might be an attractive option for developing FC-relieving medications.

8.
Front Public Health ; 10: 1000048, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36568765

RESUMO

The World Health Organization (WHO) estimates that about one-third of people worldwide currently have a need for rehabilitation. This demand is expected to increase in the coming years due to changes in population health and characteristics. For example, with the intensification of global aging, the rehabilitation needs of patients with chronic diseases and disabilities, postoperative dysfunction, and cognitive impairment continue to grow, and emergencies such as conflicts, disasters, and epidemics may lead to a surge in rehabilitation needs. Early and sustained rehabilitation could reduce complications, improve function, and reduce disability in affected populations, but rehabilitation services are often underestimated due to underfunding and poor short-term outcomes. WHO sees rehabilitation as an essential part of achieving universal health coverage and the Sustainable Development Goals. With the development of China's economy and society and the trend of an aging population, the demand for rehabilitation therapists is growing rapidly. Since the development of rehabilitation education in China at the beginning of this century, great progress has been made in both the training mode and the number of people trained, especially in the construction of higher education of rehabilitation in related colleges and universities. Through descriptive qualitative analysis, this study collected information from national policy documents and official websites of colleges and universities on policies concerning degree systems, cultivating goals and ideas, courses, education internationalization, continuing education in practice, standardized training after graduation, the number of colleges and universities with rehabilitation therapy related majors in China, and summarizes the current situation of the development of rehabilitation personnel education in Chinese colleges and universities. Judging from the results, during the development of rehabilitation education, China has continuously improved in terms of policy support, educational goals and concepts, the number and quality of institutions, degree systems, and internationalization, while gradually adapting to China's development status. This also provides direction and feasible suggestions for China to improve the rehabilitation education development system and formulate a national rehabilitation education plan in the future to deal with the challenge of aging.


Assuntos
Envelhecimento , Humanos , Idoso , China
9.
Occup Ther Int ; 2022: 6040457, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36262376

RESUMO

Autistic children, also known as "children from the stars", have been discovered for more than half a century, but there is still no unified conclusion on the diagnosis, causes, manifestations, and education of autism. The current theory and practice suggest that there is a need to improve the treatment and education of these children. According to existing theories and practices, most autistic children show a special interest in music, and music is very effective in the treatment of autistic children, and through musical activities, children with autism can improve their language, social and emotional, cognitive, and sensorimotor development. In this paper, we record and observe the music classes of children with autism. We select two classes with a total of seven children with autism as the observation subjects in the music classes, record the changes in various aspects and behavioral performance of these seven children with autism in the music activities, and analyze and summarize them. The main purpose of this study is to analyze and summarize how the three major music teaching methods are implemented in the music classroom for autistic children and how they can help autistic children with different characteristics. In the end, we summarize the main problems of music teaching for autistic children found in practice and try to make some suggestions, hoping to provide reference for scholars who study music education for autistic children. The music teaching activities were effective in improving the children's joint attention, movement imitation, rhythm imitation, and cooperation ability, and all three children improved to varying degrees, fulfilling the goals of the teaching activities. The behavioral analysis of the three children during the teaching activities showed that the three children improved their ability to sit comfortably, awareness, musical ability, and rule awareness and reduced inappropriate behaviors and bad emotions, which proved that music education could improve the social and cognitive skills of the children.


Assuntos
Transtorno Autístico , Música , Terapia Ocupacional , Criança , Humanos , Música/psicologia , Transtorno Autístico/terapia , Emoções , Atenção
10.
Atmos Environ (1994) ; 2762022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35814352

RESUMO

A number of studies have found differing associations of disease outcomes with PM2.5 components (or species) and sources (e.g., biomass burning, diesel vehicles and gasoline vehicles). Here, a unique method of fusing daily chemical transport model (Community Multiscale Air Quality Modeling) results with observations has been utilized to generate spatiotemporal fields of the concentrations of major gaseous pollutants (CO, NO2, NOx, O3, and SO2), total PM2.5 mass, and speciated PM2.5 (including crustal elements) over North Carolina for 2002-2010. The fused results are then used in chemical mass balance source apportionment model, CMBGC-Iteration, which uses both gas constraint and particulate matter concentrations to quantify source impacts. The method, as applied to North Carolina, quantifies the impacts of ten source categories and provides estimates of source contributions to PM2.5 concentrations. The ten source categories include both primary sources (diesel vehicles, gasoline vehicles, dust, biomass burning, coal-fired power plants and sea salt) and secondary components (ammonium sulfate, ammonium bisulfate, ammonium nitrate and secondary organic carbon). The results show a steady decrease in anthropogenic source impacts, especially from diesel vehicles and coal-fired power plants. Secondary pollutant components accounted for approximately 70% of PM2.5 mass. This study demonstrates an ability to provide spatiotemporal fields of both PM components and source impacts using a chemical transport model fused with observation data, linked to a receptor-based source apportionment method, to develop spatiotemporal fields of multiple pollutants.

11.
J Healthc Eng ; 2022: 9372807, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35392154

RESUMO

The aim of the study is to build a tongue image intelligent analysis "end-to-end" deep learning network based on a tongue diagnosis image of traditional Chinese medicine. The tongue target region in the original image was segmented by the UNet tongue segmentation model at the front end of the network. After segmentation, the feature vector of the tongue target region was extracted by the ResNet network, and then the blood pressure on the day of shooting was fused with the feature vector extracted by the ResNet network through the convolution operation method to complete the extraction of two groups of data of tongue feature and fusion feature. Based on analyzing the data of blood pressure, tongue image, and their fusion at the end of the network, four regression analysis methods were used to predict the stage mean value. After training, the model is tested with the test set data, and the test results are evaluated with mean absolute error (MAE). The prediction error of the model based on the fusion data of tongue image and blood pressure on the day of shooting was lower than that of the other two data modes. The UNet tongue segmentation model combined with the ResNet network can realize the automatic extraction of tongue image features. The extracted features combined with machine learning modeling can be used to explore the complex hierarchical mathematical association between tongue image and clinical data. The experimental results show that the multimodal data fusion method is an important way to mine the clinical value of the TCM tongue image.


Assuntos
Aprendizado Profundo , Análise de Dados , Humanos , Aprendizado de Máquina , Tecnologia , Língua/diagnóstico por imagem
12.
IEEE J Biomed Health Inform ; 24(9): 2481-2489, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32310809

RESUMO

Automatic tongue image segmentation and tongue image classification are two crucial tongue characterization tasks in traditional Chinese medicine (TCM). Due to the complexity of tongue segmentation and fine-grained traits of tongue image classification, both tasks are challenging. Fortunately, from the perspective of computer vision, these two tasks are highly interrelated, making them compatible with the idea of Multi-Task Joint learning (MTL). By sharing the underlying parameters and adding two different task loss functions, an MTL method for segmenting and classifying tongue images is proposed in this paper. Moreover, two state-of-the-art deep neural network variants (UNET and Discriminative Filter Learning (DFL)) are fused into the MTL to perform these two tasks. To the best of our knowledge, our method is the first attempt to manage both tasks simultaneously with MTL. We conducted extensive experiments with the proposed method. The experimental results show that our joint method outperforms the existing tongue characterization methods. Besides, visualizations and ablation studies are provided to aid in understanding our approach, which suggest that our method is highly consistent with human perception.


Assuntos
Redes Neurais de Computação , Língua , Humanos , Língua/diagnóstico por imagem
13.
Artigo em Inglês | MEDLINE | ID: mdl-32089725

RESUMO

OBJECTIVE: Physical activity plays a specific role in the fundamental aspect of diabetes care. It is necessary to develop exercise programs for these patients. The aim of this systematic review is to summarize current evidence regarding the effectiveness of meditative movement in patients with type 2 diabetes. METHODS: The following databases were searched: PubMed, CENTRAL, Web of Science, Ovid LWW, and EMBASE. Two independent investigators searched and screened the studies by finding duplications, excluding irrelevant titles and abstracts, and then selecting eligible studies by reviewing full texts. 21 studies fulfilled the inclusion criteria. Meta-analyses were performed on glycated hemoglobin (HbA1c), fasting blood glucose (FBG) and postprandial blood glucose (PPBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and body mass index (BMI). RESULTS: Meta-analyses showed that meditative movements significantly improved FBG, HbA1c, PPBG, TC, LDL-C, and HDL-C. No improvement was found in BMI. CONCLUSIONS: The results demonstrated a favorable effect or tendency of meditative movements to improve blood glucose and blood lipid levels in patients with type 2 diabetes mellitus. The special effects of meditative movements in type 2 diabetes mellitus patients need further research.

14.
Medicine (Baltimore) ; 98(43): e17718, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651905

RESUMO

BACKGROUND: Diabetic gastroparesis (DG) is a common complication to diabetes mellitus (DM). A lot of clinical researches have focused on acupoint catgut embedding for diabetic gastroparesis. However, there is no systematic review and meta-analysis has been conducted. We aim to systematically review the effect of acupoint catgut embedding on diabetic gastroparesis. METHODS: The databases including PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Ovid LWW, EMBASE, CNKI, Wanfang Database will be searched. Studies published from the time when the database establishment to July 2019 will be retrieved. Randomized controlled clinical trials and quasi-randomized controlled trials on acupoint catgut embedding for diabetic gastroparesis will be included. The primary outcomes are gastroparesis Cardinal Symptom Index (GCSI) or a similar scale to score dyspeptic symptoms. RevMan V.5.3 software will be used to perform the analyses. RESULTS: This study will provide a high-quality synthesis of the effectiveness and safety of acupoint catgut embedding for diabetic gastroparesis. CONCLUSION: This systematic review will provide a high-quality evidence to judge whether the acupoint catgut embedding is beneficial to treat diabetic gastroparesis. PROSPERO REGISTRATION NUMBER: CRD42019140951.


Assuntos
Terapia por Acupuntura/métodos , Categute , Complicações do Diabetes/terapia , Gastroparesia/terapia , Humanos
15.
Medicine (Baltimore) ; 98(19): e15639, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083263

RESUMO

BACKGROUND: Type 2 diabetes is one of the most common and complex chronic disease. A lot of clinical researches have focused on meditative movement for type 2 diabetes. However, there is no systematic review and meta-analysis has been conducted. We aim to systematically review the effect of meditative movement on the type 2 diabetes care. METHODS: The databases including PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Ovid LWW, EMBASE will be searched. Studies published from the time when the database establishment to December 2018 will be retrieved. RCTs study on meditative movement for glucose control in patients with type 2 diabetes will be included. The primary outcomes are HbA1c, fasting blood glucose, and postprandial blood glucose (PPBG). RevMan V.5.3 software will be used to perform the analyses. RESULTS: This study will provide high-quality synthesis of effectiveness and safety of meditation movement for type 2 diabetes. CONCLUSION: This systematic review will provide high-quality evidence to judge whether the meditative movement is beneficial to glucose control in patients with type 2 diabetes.PROSPERO registration number: CRD42019128495.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Metanálise como Assunto , Terapias Mente-Corpo , Revisões Sistemáticas como Assunto , Glicemia , Diabetes Mellitus Tipo 2/sangue , Humanos , Terapias Mente-Corpo/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto
16.
BMC Complement Altern Med ; 19(1): 63, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30871517

RESUMO

BACKGROUND: Physical activity is an important part of the diabetes management plan. However, the effects caused by different training durations and styles of Tai Chi have not been evaluated. We conducted an updated systematic review of the effects of Tai Chi on patients with type 2 diabetes based on different training durations and styles. METHODS: We performed a search for Chinese and English studies in 8 databases. Two reviewers independently selected the eligible trials and conducted a critical appraisal of the methodological quality. RESULTS: Seventeen trials were included. Tai Chi was found to have reduced fasting blood glucose (FBG) [SMD = - 0.54, 95% CI (- 0.91, - 0.16), P = 0.005] and HbA1c [SMD = - 0.68, 95% CI (- 1.17, - 0.19), P = 0.006] overall, compared with a control group. Considering the subgroup analysis, the pooled results showed that 24 movements or Yang-style Tai Chi did not significantly reduce FBG after a duration of ≤3 months [SMD = - 0.46, 95% CI (- 1.42, 0.50), P = 0.35] or > 3 months [SMD = - 0.50, 95% CI (- 1.49, 0.49), P = 0.32], nor did it reduce HbA1c [SMD = - 1.22, 95% CI (- 2.90, 0.47), P = 0.16] after a duration > 3 months in all studies. However, other styles of Tai Chi significantly reduced FBG [SMD = - 0.90, 95% CI (- 1.28, - 0.52), P < 0.00001] and HbA1c [SMD = - 0.90, 95% CI (- 1.28, - 0.52), P < 0.00001] after a duration > 3 months, while no significant reduction in FBG [SMD = - 0.34, 95% CI (- 0.76, 0.08), P = 0.12] or HbA1c [SMD = - 0.34, 95% CI (- 0.76, 0.08), P = 0.12] was found after a duration ≤3 months. CONCLUSIONS: Tai Chi seems to be effective in treating type 2 diabetes. Different training durations and styles result in variable effectiveness. The evidence was insufficient to support whether long-term Tai Chi training was more effective.


Assuntos
Glicemia/fisiologia , Diabetes Mellitus Tipo 2 , Tai Chi Chuan , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/terapia , Humanos
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