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Laparoscopic surgery for benign and malign diseases of the digestive system:Indications,limitations,and evidence

World Journal of Gastroenterology 2014年第17期20卷 4883-4891页

作者： Markus Alexander küper Friederike Eisner alfred k?nigsrainer J?rg Glatzle Department for General and Visceral Surgery Bundeswehr Hospital BerlinD-10115 BerlinGermany Department for General Visceral and Transplant SurgeryUniversity Hospital Tübingen72076 TübingenGermany

The laparoscopic technique was introduced in gastrointestinal surgery in the mid 1980s. Since then, the development of this technique has been extraordinary. Triggered by technical innovations (stapling devices or coagulation/dissecting devices), nowadays any type of gastrointestinal resection has been successfully performed laparoscopically and can be performed laparoscopically dependent on the patient’s condition. This summary gives an overview over 30 years of laparoscopic surgery with focus on today’s indications and evidence. Main indications remain the more common procedures, e.g., appendectomy, cholecystectomy, bariatric procedures or colorectal resections. For all these indications, the laparoscopic approach has become the gold standard with less perioperative morbidity. Regarding oncological outcome there have been several high-quality randomized controlled trials which demonstrated equivalency between laparoscopic and open colorectal resections. Less common procedures like esophagectomy, oncological gastrectomy, liver and pancreatic resections can be performed successfully as well by an experienced surgeon. However, the evidence for these special indications is poor and a general recommendation cannot be given. In conclusion, laparoscopic surgery has revolutionized the field of gastrointestinal surgery by reducing perioperative morbidity without disregarding surgical principles especially in oncological surgery.

关键词： Laparoscopy Gastrointestinal surgery Esophagus Stomach Cholecystectomy Colorectal surgery Liver resection Pancreas resection Laparoscopic resection of gastrointestinal

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Experience after 100 patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

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World Journal of Gastroenterology 2012年第17期18卷 2061-2066页

作者： Ingmar knigsrainer Derek Zieker Jrg Glatzle Olivia Lauk Julia klimek Stephan Symons Bjrn Brücher Stefan Beckert alfred knigsrainer Department of Surgery University of TübingenHoppeSeyler-Strasse 3D-72076 TübingenGermany Center for Bioinformatics Tübingen Sand 14D-72076 TübingenGermany

AIM:To investigate perioperative patient morbidity/mortality and outcome after cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC).METHODS:Of 150 patients 100 were treated with cytoreductive surgery and HIPEC and retrospectively *** and postoperative follow-up data were *** mass index(BMI),age and peritoneal carcinomatosis index(PCI) were chosen as selection criteria with regard to tumor-free survival and perioperative morbidity for this multimodal ***:CRS with HIPEC was successfully performed in 100 out of 150 *** patients were excluded because of intraoperative *** PCI was 17(1-39).In 89% a radical resection(CC0/CC1) was *** patient died postoperatively due to multiorgan *** PCI,age nor BMI was a risk factor for postoperative complications/outcome according to the DINDO *** 9% Re-CRS with HIPEC was performed during the follow-up ***:Patient selection remains the most important *** PCI,age nor BMI alone should be an exclusion criterion for this multimodal therapy.

关键词： Peritoneal carcinomatosis Single-center experience Hyperthermic intraoperative chemotherapy Complications Risk assessment Selection criteria

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The effect of Common Cuckoo parasitism on the annual productivity of a host population

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Avian Research 2024年第2期15卷 287-291页

作者： alfred Trnka Department of Biology University of TrnavaPriemyselna 491843TrnavaSlovakia

Avian interspecific brood parasitism is an excellent system for studying coevolutionary processes in nature because brood parasites directly affect host reproductive *** research on avian brood parasitism has,therefore,focused primarily on specific host anti-parasite behaviours and parasite ***,the population-level consequences of brood parasitism for host species are poorly *** study investigated the effect of Common Cuckoo(Cuculus canorus)parasitism on the productivity of a local population of the Great Reed Warbler(Acrocephalus arundinaceus)host in south-western Slovakia.A total of 495 females nesting at the studied site successfully fledged 1321 of their own young and 63 young of the Common Cuckoo over the course of 15 years(2008-2022),and the annual rate of successful parasitism ranged from 18% to 44% over this *** predicted,higher rates of successful cuckoo parasitism significantly reduced the annual productivity of the local Great Reed Warbler population,and its contribution to decreased host reproductive success was at about the same rate as overall nest failure caused by predation and other environmental *** a heavily parasitized population was probably maintained by immigrants from other populations and density-dependent selection,which is also consistent with source-sink ***,further long-term studies monitoring parasitized populations are required to confirm these findings.

关键词： Acrocephalus arundinaceus Cuculus canorus Great Reed Warbler Population growth Reproductive success

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Development and internal validation of the Comprehensive ALPPS Preoperative Risk Assessment(CAPRA)score:is the patient suitable for Associating Liver Partition and Portal vein ligation for Staged hepatectomy(ALPPS)?

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Hepatobiliary Surgery and Nutrition 2022年第1期11卷 52-66,I0007,I0008页

作者： Ivan Capobianco karl J.Oldhafer Mohammed-Hossein Fard-Aghaie Ricardo Robles-Campos Roberto Brusadin Henrik Petrowsky Michael Linecker Arianeb Mehrabi katrin Hoffmann Jun Li Asmus Heumann Roberto Hernandez-Alejandro Mauro Enrique Tun-Abraham Elio Jovine Matteo Serenari Bergthor Bjornsson Per Sandström Ruslan Alikhanov Mikhail Efanov Paolo Muiesan Andrea Schlegel Thomas M.van Gulik Pim B.Olthof Gregor Alexander Stavrou Lina Maria Serna-Higuita alfred königsrainer Silvio Nadalin Department of General Visceral and Transplant SurgeryUniversity Hospital TübingenTübingenGermany Department of General and Abdominal Surgery Asklepios Hospital BarmbekHamburgGermany Department of Surgery Virgen de la Arrixaca Clinic and University HospitalMurciaSpain Swiss HPB and Transplantation Center Department of SurgeryZurich University HospitalZurichSwitzerland Department of General Visceraland Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany General Visceral and Thoracic Surgery Department and ClinicHamburg-Eppendorf University Medical CenterHamburgGermany Division of Transplantation and Hepatobiliary Surgery University of RochesterRochesterNYUSA Division of HPB Surgery and Liver Transplantation Department of SurgeryLondon Health Sciences CentreLondonCanada General and Emergency Surgery Unit Azienda Ospedaliero-Universitaria di BolognaMaggiore HospitalBolognaItaly General Surgery and Transplantation Unit Azienda Ospedaliero-Universitaria di BolognaSant’Orsola-Malpighi HospitalBolognaItaly Department of Surgery in Linköping and Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden Department of Hepatopancreatobiliary Surgery Moscow Clinical Scientific CenterMoscowRussia Liver Unit Queen Elizabeth Hospital BirminghamUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK Department of Surgery Amsterdam UMC(Location AMC)University of AmsterdamAmsterdamThe Netherlands Department of General Abdominal and Thoracic SurgerySurgical OncologySaarbruecken General HospitalSaarbrueckenGermany Department of Clinical Epidemiology and Applied Biometry University of TübingenTübingenGermany

Background:Preoperative patient selection in Associating Liver Partition and Portal vein ligation for Staged hepatectomy(ALPPS)is not always reliable with currently available scores,particularly in patients with primary liver *** study aims to(I)to determine whether comorbidities and patients characteristics are a risk factor in ALPPS and(II)to create a score predicting 90-day mortality ***:Thirteen high-volume centers participated in this retrospective multicentric study.A risk analysis based on patient characteristics,underlying disease and procedure type was performed to identify risk factors and model the Comprehensive ALPPS Preoperative Risk Assessment(CAPRA)score.A nonparametric receiver operating characteristic analysis was performed to estimate the predictive ability of our score against the Charlson Comorbidity Index(CCI),the age-adjusted CCI(aCCI),the ALPPS risk score before Stage 1(ALPPS-RS1)and Stage 2(ALPPS-RS2).The model was internally validated applying ***:A total of 451 patients were *** was 14.4%.The CAPRA score is calculated based on the following formula:(0.1×age)−(2×BSA)+1(in the presence of primary liver tumor)+1(in the presence of severe cardiovascular disease)+2(in the presence of moderate or severe diabetes)+2(in the presence of renal disease)+2(if classic ALPPS is planned).The predictive ability was 0.837 for the CAPRA score,0.443 for CCI,0.519 for aCCI,0.693 for ALPPS-RS1 and 0.807 for *** 1,000 cycles of bootstrapping the C statistic was *** accuracy plot revealed a cut-off for optimal prediction of postoperative mortality of ***:Comorbidities play an important role in ALPPS and should be carefully considered when planning the *** assessing the patient’s preoperative condition in relation to ALPPS,the CAPRA score has a very good ability to predict postoperative mortality.

关键词： Associating Liver Partition and Portal vein ligation for Staged hepatectomy(ALPPS) comorbidity mortality prediction model patient selection

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Performance of Continuous Wavelet Transform over Fourier Transform in Features Resolutions

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International Journal of Geosciences 2024年第2期15卷 87-105页

作者： Michael k. Appiah Sylvester k. Danuor alfred k. Bienibuor Department of Physics Kwame Nkrumah University of Science and Technology (KNUST) Kumasi Ghana Department of Chemical Sciences University of Energy and Natural Resources Sunyani Ghana

This study presents a comparative analysis of two image enhancement techniques, Continuous Wavelet Transform (CWT) and Fast Fourier Transform (FFT), in the context of improving the clarity of high-quality 3D seismic data obtained from the Tano Basin in West Africa, Ghana. The research focuses on a comparative analysis of image clarity in seismic attribute analysis to facilitate the identification of reservoir features within the subsurface structures. The findings of the study indicate that CWT has a significant advantage over FFT in terms of image quality and identifying subsurface structures. The results demonstrate the superior performance of CWT in providing a better representation, making it more effective for seismic attribute analysis. The study highlights the importance of choosing the appropriate image enhancement technique based on the specific application needs and the broader context of the study. While CWT provides high-quality images and superior performance in identifying subsurface structures, the selection between these methods should be made judiciously, taking into account the objectives of the study and the characteristics of the signals being analyzed. The research provides valuable insights into the decision-making process for selecting image enhancement techniques in seismic data analysis, helping researchers and practitioners make informed choices that cater to the unique requirements of their studies. Ultimately, this study contributes to the advancement of the field of subsurface imaging and geological feature identification.

关键词： Continuous Wavelet Transform (CWT) Fast Fourier Transform (FFT) Reservoir Characterization Tano Basin Seismic Data Spectral Decomposition

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Quantitative Identification of Delamination Damage in Composite Structure Based on Distributed Optical Fiber Sensors and Model Updating

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Structural Durability & Health Monitoring 2024年第6期18卷 785-803页

作者： Hao Xu Jing Wang Rubin Zhu alfred Strauss Maosen Cao Zhanjun Wu School of Materials Science and Engineering Dalian University of TechnologyDalian116000China School of Mechanics and Aerospace Engineering Dalian University of TechnologyDalian116000China Department of Civil Engineering and Natural Hazards University of Natural Resources and Life SciencesVienna1180Austria Department of Engineering Mechanics Hohai UniversityNanjingChina

Delamination is a prevalent type of damage in composite laminate *** accumulation degrades structural performance and threatens the safety and integrity of *** study presents a method for the quantitative identification of delamination identification in composite materials,leveraging distributed optical fiber sensors and a model updating ***,a numerical analysis is performed to establish a parameterized finite element model of the composite ***,this model subsequently generates a database of strain responses corresponding to damage of varying sizes and *** radial basis function neural network surrogate model is then constructed based on the numerical simulation results and strain responses captured from the distributed fiber optic ***,a multi-island genetic algorithm is employed for global optimization to identify the size and location of the *** efficacy of the proposed method is validated through numerical examples and experiment studies,examining the correlations between damage location,damage size,and strain *** findings confirm that the model updating technique,in conjunction with distributed fiber optic sensors,can precisely identify delamination in composite structures.

关键词： Composite structures fiber optic sensor damage identification model updating surrogate model

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Turbidite Dynamics and Hydrocarbon Reservoir Formation in the Tano Basin: A Coastal West African Perspective

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International Journal of Geosciences 2024年第2期15卷 137-161页

作者： Michael k. Appiah Sylvester k. Danuor Striggner Bedu-Addo alfred k. Bienibuor Department of Physics Kwame Nkrumah University of Science and Technology (KNUST) Kumasi Ghana Department of Chemical Sciences University of Energy and Natural Resources Sunyani Ghana

This study examines the turbidite dynamics and hydrocarbon reservoir formation in Ghana’s Tano Basin, which is located in coastal West Africa. Through an exploration of geological processes spanning millions of years, we uncover key factors shaping hydrocarbon accumulation, including source rock richness, temperature, pressure, and geological structures. The research offers valuable insights applicable to exploration, management, and sustainable resource exploitation in coastal West Africa. It facilitates the identification of exploration targets with higher hydrocarbon potential, enables the anticipation of reservoir potential within the Tano Basin, and assists in tailoring exploration and management strategies to specific geological conditions of the Tano Basin. Analysis of fluvial channels sheds light on their impact on landscape formation and hydrocarbon exploration. The investigation into turbidite systems unveils intricate interactions involving tectonics, sea-level fluctuations, and sedimentation patterns, influencing the development of reservoirs. An understanding of sediment transport and depositional settings is essential for efficient reservoir management. Geomorphological features, such as channels, submarine canyons, and distinct channel types, are essential in this situation. A detailed examination of turbidite channel structures, encompassing canyons, channel complexes, convex channels, and U-shaped channels, provides valuable insights and aids in identifying exploration targets like basal lag, channel levees, and lobes. These findings underscore the enduring significance of turbidite systems as conduits for sediment transport, contributing to enhanced reservoir management and efficient hydrocarbon production. The study also highlights how important it is to examine the configuration of sedimentary layers, stacking patterns, and angular laminated facies to identify turbidites, understand reservoir distribution, and improve well design. The dynamic nat

关键词： Reservoir Characterization Tano Basin Seismic Data Hydrocarbon Potential Channels Turbidites

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Prevalence of visual impairment and estimation of refractive errors among school children in kakamega,kenya

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International Journal of Ophthalmology(English edition) 2024年第5期17卷 932-939页

作者： Isabel Signes-Soler alfred Ragot Sheilah Nangena Andrew Wekesa Raúl Montalbán Llamusí Department of Optics and Optometry and Vision Sciences Universidat de ValènciaBurjassotValencia 46010Spain NGO Vision Without Borders(Visio Sense Fronteres VSF)Calpe 03710AlicanteSpain Masinde Muliro University of Science and Technology P.O Box 190-50100KakamegaKenya Clinica Baviera Alicante C/Ausóy Monzó 16Alicante 03006Spain

AIM:To investigate the prevalence of visual impairment(VI)and provide an estimation of uncorrected refractive errors in school-aged children,conducted by optometry students as a community ***:The study was *** 3343 participants were included in the *** initial examination involved assessing the uncorrected distance visual acuity(UDVA)and visual acuity(VA)while using a+2.00 D *** inclusion criteria for a subsequent comprehensive cycloplegic eye examination,performed by an optometrist,were as follows:a UDVA<0.6 decimal(0.20 logMAR)and/or a VA with+2.00 D≥0.8 decimal(0.96 logMAR).RESULTS:The sample had a mean age of 10.92±2.13y(range 4 to 17y),and 51.3%of the children were female(n=1715).The majority of the children(89.7%)fell within the age range of 8 to *** the ethnic groups,the highest representation was from the Luhya group(60.6%)followed by Luo(20.4%).Mean logMAR UDVA choosing the best eye for each student was 0.29±0.17(range 1.70 to 0.22).Out of the total,246 participants(7.4%)had a full eye *** estimated prevalence of myopia(defined as spherical equivalent≤-0.5 D)was found to be 1.45%of the total *** around 0.18%of the total sample had hyperopia value exceeding+1.75 *** astigmatism(cil<-0.75 D)was found in 0.21%(7/3343)of the *** VI prevalence was 1.26%of the total *** our cases of VI,76.2%could be attributed to uncorrected refractive *** was detected in 0.66%(22/3343)of the screened *** was no statistically significant correlation observed between age or gender and refractive ***:The primary cause of VI is determined to be uncorrected refractive errors,with myopia being the most prevalent refractive error *** findings underscore the significance of early identification and correction of refractive errors in school-aged children as a means to alleviate the impact of VI.

关键词： visual impairment refractive errors myopia amblyopia sustainable development goals

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Three- and Four-Dimensional Generalized Pythagorean Numbers

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Advances in Pure Mathematics 2024年第1期14卷 1-15页

作者： alfred Wünsche Institute of Physics Humboldt University Berlin Germany

The Pythagorean triples (a, b | c) of planar geometry which satisfy the equation a2+b2=c2 with integers (a, b, c) are generalized to 3D-Pythagorean quadruples (a, b, c | d) of spatial geometry which satisfy the equation a2+b2+c2=d2 with integers (a, b, c, d). Rules for a parametrization of the numbers (a, b, c, d) are derived and a list of all possible nonequivalent cases without common divisors up to d2 is established. The 3D-Pythagorean quadruples are then generalized to 4D-Pythagorean quintuples (a, b, c, d | e) which satisfy the equation a2+b2+c2+d2=e2 and a parametrization is derived. Relations to the 4-square identity are discussed which leads also to the N-dimensional case. The initial 3D- and 4D-Pythagorean numbers are explicitly calculated up to d2, respectively, e2.

关键词： Number Theory Pythagorean Triples Tesseract 4-Square Identity Diophantine Equation

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Confucius and American Democracy

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China Today 2024年第6期73卷 48-50页

作者： alfred HORNUNG The Obama Institute for Transnational American Studies Johannes Gutenberg UniversityMainzGermany

UPON the establishment of European universities in the Middle Ages,the educational system in Western countries became characterized by an essentially Eurocentric *** was reflected in the study of Latin and Greek in high school,and in basing public life and political systems on philosophies of classical *** work of the influential Chinese philosopher Confucius(551-479 B.C.),a near-contemporary of the major Greek philosophers Socrates(469-399 B.C.),Plato(428-348 B.C.)and Aristotle(384-322 B.C.),whose ethical and political ideas entered into the constitutions of European states,remained unknown.

关键词： Latin Middle Confucius

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