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Impaired immune reaction and increased lactate and C-reactive protein for early prediction of severe morbidity and pancreatic fistula after pancreatoduodenectomy

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Hepatobiliary & Pancreatic Diseases International 2020年第1期19卷 58-67页

作者： Mario Rodriguez-Lopez Francisco J.Tejero-Pintor Martin Bailon-Cuadrado Asterio Barrera-Rebollo baltasar perez-saborido David Pacheco-Sanchez General and Digestive Surgery Department Rio-Hortega University Hospital

Background: Prediction of complications after pancreatoduodenectomy (PD) remains of interest. Blood parameters and biomarkers during rst and second postoperative days (POD1, POD2) may be early indi- cators of complications. Methods: This case-control study included 50 patients. Baseline, POD1 and POD2 values of leukocytes, neutrophils, lymphocytes, platelets, hemoglobin, C-reactive protein (CRP), procalcitonin and arterial lactate were compared between individuals presenting Clavien ≥ III morbidity, pancreatic stula (PF) or clinically relevant PF (CRPF) and those without these morbidities. Common variables reaching signi cance were further analyzed in order to calculate a predictive score. Results: Severe morbidity, PF and CRPF rates were 28.0%, 26.0% and 14.0%, respectively. Patients with severe morbidity had lower leukocytes on POD2 (P=0.04). Patients with PF presented higher CRP on POD2 (P=0.001), higher lactate on POD1 (P=0.007) and POD2 (P=0.008), and lower lymphocytes on POD1 (P=0.007) and POD2 (P=0.008). Patients with CRPF had lower leukocytes and neutrophils on POD1 (P =0.048, P =0.038), lower lymphocytes on POD1 (P =0.001) and POD2 (P =0.003), and higher CRP on POD2 (P =0.001). Baseline parameters and procalcitonin obtained no statistical associations. Score was de ned according to lymphocytes on POD1 < 650/μL and CRP on POD2 ≥ 250 mg/L allocating patients in 3 risk categories. PF and CRPF rates were statistically higher as risk category increased (P<0.001). Receiver operating characteristic curves and Hosmer Lemeshow tests showed a good accuracy. Conclusions: Impaired immunological reaction during early postoperative period (lower leukocytes and, particularly, lymphocytes) in response to surgical aggression would favor complications after PD. Likewise, acidosis (higher arterial lactate) could behave as risk factor of PF. An elevated CRP on POD2 is also an early biomarker of PF. Our novel score based on postoperative lymphocyte count and CRP seems reliable

关键词： Pancreatoduodenectomy Morbidity Pancreatic fistula Biomarker Prediction Score

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Severe morbidity after pancreatectomy is accurately pre dicte d by preoperative pancreatic resection score(PREPARE): A prospective validation analysis from a medium-volume center

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Hepatobiliary & Pancreatic Diseases International 2018年第6期17卷 559-565页

作者： Mario Rodriguez-Lopez Francisco J. Tejero-Pintor baltasar perez-saborido Asterio Barrera-Rebollo Martin Bailon-Cuadrado David Pacheco-Sanchez General and Digestive Surgery Department Rio-Hortega University Hospital

Background: Major morbidity in pancreatic surgery remains high. Different scores for predicting complications have been described. Preoperative pancreatic resection(PREPARE) score is based on objective preoperative variables and offers good predictive accuracy for Clavien ≥ III complications. This study aimed to validate this score and analyze other preoperative variables in a prospective study performed in a medium-volume center. Methods: A total of 50 pancreatic resections were included. Preoperative variables were registered and PREPARE was calculated. The main outcome was severe morbidity(Clavien ≥ III) up to 30 days after discharge. The secondary outcomes were length of stay(LOS) and readmission. Statistical validation was performed to compare severe morbidity rate among the scores categories. Association with other preoperative variables(not included in PREPARE) was also tested. Results: Of the 50 pancreatic resections, the severe morbidity was 34.0%, with median LOS of 11 days. Readmission rate was 25.5%. Severe morbidity rates according to PREPARE categories were 18.5% in lowrisk group, 41.7% in intermediate-risk group, and 63.6% in high-risk group, respectively( P = 0.023). The accuracy was 72%(Hosmer–Lemeshow, P = 0.86). ROC curve was obtained both for PREPARE score expressed as incremental values and categorized as the three risk groups, showing an area under curve(AUC) of 0.736(95% CI: 0.586–0.887; P = 0.007) and 0.712(95% CI: 0.555–0.869; P = 0.015), respectively. PREPARE was significant in multivariate analysis. Median LOS was statistically higher as PREPARE category increases(9, 11 and 15 days in low-, intermediate-and high-risk groups, respectively; P = 0.009). Readmission was not associated with any variables. Conclusions: PREPARE behaves as an independent risk factor for severe morbidity after pancreatic surgery. Score validation shows good accuracy prediction. Increasing PREPARE category is also associated with longer LOS.

关键词： Pancreatic surgery Morbidity Complications Preoperative pancreatic resection score Validation

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Preoperative pancreatic resection score:a preliminary prospective validation from Spain

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Hepatobiliary & Pancreatic Diseases International 2016年第6期15卷 667-668页

作者： Mario Rodriguez-Lopez Martin Bailon-Cuadrado Francisco J Tejero-Pintor baltasar perez-saborido Enrique Asensio-Diaz Asterio Barrera-Rebollo General and Digestive Surgery Department Rio Hortega University HospitalDulzaina 247012ValladolidSpain

To the Editor：We read with outstanding interest the article by Celik et al. It is the first external description of the Hamburg＇s preoperative pancreatic resection （PREPARE） score since it was published in 2014 by Uzunoglu et al. According to the latter authors, it is necessary to stratify risk of major morbidity and mortality before performing a pancreatic resection, and PREPARE score is a simple index, validated in a multicenter cohort of patients undergoing this group of technically demanding procedures.

关键词： Preoperative pancreatic resection score

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A review of GaN RF devices and power amplifiers for 5G communication applications

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Fundamental Research 2025年第1期5卷 315-331页

作者： Lu, Hao Zhang, Meng Yang, Ling Hou, Bin Martinez, Rafael perez Mi, Minhan Du, Jiale Deng, Longge Wu, Mei Chowdhury, Srabanti Ma, Xiaohua Hao, Yue School of Microelectronics Xidian University Xi'an 710071 China Department of Electrical Engineering Stanford University Stanford 94305 CA United States

In the emerging 5G and beyond 5G (B5G) era, the spotlight is sharply focused on the power amplifier, a critical component with stringent specification requirements that dictates the performance of the transmitter. The gallium nitride (GaN) device, with its superior inherent properties, is surfacing as a front-runner for power amplifier applications. The increasing demand for high frequency, high linearity, and cost-effective GaN power amplifiers is driven by anticipated traffic surges and the need for extensive 5G deployment. This paper offers a thorough review and future perspective on research developments in RF GaN device technology. It encompasses critical issues in advanced device and circuit technology, with a focus on high frequency, high linearity, cost-effective GaN-on-Si high electron mobility transistors (HEMTs), and compact modeling. This work aims to serve as a guide for the utilization of GaN HEMTs in 5G communication applications. © 2023

关键词： 5G Gallium nitride GaN-on-Si HEMTs High frequency High linearity

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奇妙的萤火虫魅力十足又对科学深具价值的萤火虫,未来却充满变数

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空中英语教室(高级版.彭蒙惠英语) 2025年第3期 32-34,49,50页

作者： Adriana perez 不详

对于许多在密西西比河以东长大的人来说,黄色的闪烁光芒点缀着如梦如幻的童年回忆。在新英格兰长大的人叫它们萤火虫,但从美国中西部到南方的人们称它们为“闪烁虫”(译注1)。不管它们在不同区域叫什么名字,它们都是温暖夏夜的常客。

关键词：新英格兰萤火虫美国中西部密西西比河童年回忆闪烁

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L^1→L^q Poincare Inequalities for 0

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Acta Mathematica Sinica,English Series 2002年第1期18卷 1-20页

作者： perez Carlos Departamento dr Matematicas. Universidad Autónoma de Madrid. 28049 Madrid. Spain

Civen two doubling measures μ and v in a metric apace (S.p)of homogeneous type. let B_0 S be a given ball. It has been a well-known result bv now (see)[1 4])theat the validity of an L^1→L^1 Poincaré inequality of the following form: f_B|f-f_B|dv≤cr(B)f_Bgdμ. for all metric balls B B_0 S, implies a variant of representation formula of fractonal integral type: |f(x)-f_(B(11))|≤C integral from n=B_(11) g(y)p(x, y)/μ(B(x, p(x, y)))dμ(y)+C(r(B_0))/(μ(B_0))integral from n=B_0 g(y)dμ(y). One of the main results of this paper shows that an L^1 to L^q Poincaré inequality for some 01, i.e.. (f_B|f-f_B|~q dv)^(1/q)≤cr(B) f_B gdμ, for all metric balls B B_0. will suffice to imply the above representation formula. As an immediate corollary, we can show that the weak-type condition. sup_(λ>0)(λv({x ∈ B:|f(x)-f_B|>λ}))/v(B)≤Gr (B)f_B gdμ. also implies the same formula. Analogous theorems related to high-order Poincaréinequalities and Sobolev spaces in metric spaces are also proved.

关键词： Sobolev spaces Representation formulas High-order derivatives Vector fields Metric spaces Polynomials Doubling measures Poincare inequalities

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Biodiversity of exopolysaccharide-producing lactic acid bacteria from Iranian traditional Kishk and optimization of EPS yield by Enterococcus spp.

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Food Bioscience 2022年第5期49卷 543-555页

作者： Paria Rahnama Vosough Mohammad Reza Edalatian Dovom Mohammad Bagher Habibi Najafi Ali Javadmanesh baltasar Mayo Food Science and Technology Department Agriculture FacultyFerdowsi University of Mashhad(FUM)P.O.Box:91775-1163MashhadIran Department of Animal Science Faculty of AgricultureFerdowsi University of Mashhad(FUM)MashhadIran Departamento de Microbiología y Bioquímica Instituto de Productos Lacteos de Asturias(IPLA-CSIC)Paseo Río Linaress/n33300VillaviciosaAsturiasSpain

The production of polysaccharides derived from lactic acid bacteria(LAB)can be a valuable alternative to current *** this study,eight samples of Kishk(traditional dairy product)were collected in sterile conditions and directly cultured on MRS agar *** purification and examination of microscopic,macroscopic characteristics and doing biochemical tests,143 isolates were selected,and the production of exopolysaccharide(EPS)was investigated by the ruthenium red and disc *** EPS production of 79 isolates was *** carbohydrate of EPS was determined by the phenol sulfuric acid ***,Enterococcus durans K48,Enterococcus faecium R114,and Enterococcus faecium T52 strains were selected as the best EPS *** optimization of EPS production was then performed using Central Composite Design(CCD)and Response Surface Methodology(RSM)*** plots showed the highest EPS yield for *** K48,*** R114,and *** T52 occurred at 38.4,37.4 and 36.7℃and pH of 5.9,5.6 and 5.8,respectively,cultured in a Sucrose-MRS *** optimal conditions,the maximum predicted and actual production of EPSs for the examined isolates were 3.18,3.21,2.99 and 3.02,3.15,3.15,g L􀀀1,*** determined by Gel Permeation Chromatography,the EPSs molecular weights were in the range of 2.93×10^(5)to 3.52×10^(5)*** of the component monosaccharides by HPLC showed that all three tested EPSs were *** appropriate evaluation,the EPSs produced by native species of LAB isolated from Iranian Kishk could be of interest for industrial applications or as functional food ingredients.

关键词： Exopolysaccharide Lactic acid bacteria Diversity Optimization RSM

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Role of dup A in virulence of Helicobacter pylori

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World Journal of Gastroenterology 2016年第46期22卷 10118-10123页

作者： Amin Talebi Bezmin Abadi Guillermo perez-perez Department of Bacteriology Faculty of Medical Sciences Tarbiat Modares University Departments of Medicine and Microbiology New York University School of Medicine and VA Medical Center

Helicobacter pylori(H. pylori) is a gastric human pathogen associated with acute and chronic gastritis, 70% of all gastric ulcers, 85% of all duodenal ulcers, and both forms of stomach cancer, mucosal-associated lymphoid tissue(MALT) lymphoma and adenocarcinoma. Recently, attention has focused on possible relationship between presence of certain virulence factor and H. pylori-associated diseases. Some contradictory data between this bacterium and related disorders has been observed since not all the colonized individuals develop to severe disease. The reported diseases plausibility related to H. pylori specific virulence factors became an interesting story about this organism. Although a number of putative virulence factors have been identified including cytotoxin-associated gene a(cag A) and vac A, there are conflicting data about their actual participation as specific risk factor for H. pylori-related diseases. Duodenal ulcer promoting gene a(dup A) is a virulence factor of H. pylori that is highly associated with duodenal ulcer development and reduced risk of gastric cancer. The prevalence of dup A in H. pylori strains isolated from western countries is relatively higher than in H. pylori strains from Asian countries. Current confusing epidemiological reports will continue unless future sophisticated and molecular studies provide data on functional and complete dup A cluster in H. pylori infected individuals. This paper elucidates available knowledge concerning role of dup A in virulence of H. pylori after a decade of its discovery.

关键词： Helicobacter pylori dup A Bacterial virulence infection Clinical outcome

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The Finite-dimensional Decomposition Property in Non-Archimedean Banach Spaces

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Acta Mathematica Sinica,English Series 2014年第11期30卷 1833-1845页

作者： Albert KUBZDELA Cristina perez-GARCIA Institute of Civil Engineering Poznań University of TechnologyUl.Piotrowo 561-138 PoznańPoland Department of Mathematics Facultad de CienciasUniversidad de CantabriaAvda.de los Castros s/n39071SantanderSpain

A non-Archimedean Banach space has the orthogonal finite-dimensional decomposition property（OFDDP） if it is the orthogonal direct sum of a sequence of finite-dimensional *** property has an influence in the non-Archimedean Grothendieck＇s approximation theory,where an open problem is the following： Let E be a non-Archimedean Banach space of countable type with the OFDDP and let D be a closed subspace of *** D have the OFDDP？ In this paper we give a negative answer to this question; we construct a Banach space of countable type with the OFDDP having a one-codimensional subspace without the *** we prove that,however,for certain classes of Banach spaces of countable type,the OFDDP is preserved by taking finite-codimensional subspaces.

关键词： Non-Archimedean Banach spaces finite-dimensional decomposition property orthogonal base

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Implementing a vector surveillanceresponse system for chagas disease control:a 4-year field trial in Nicaragua

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Infectious Diseases of Poverty 2017年第1期6卷 154-165页

作者： Kota Yoshioka Doribel Tercero Byron perez Jiro Nakamura Lenin perez Doctor of Public Health Program Harvard T.H.Chan School of Public HealthBostonUSA School of Tropical Medicine and Global Health Nagasaki UniversityNagasakiJapan Former Chagas Disease Control Project Japan International Cooperation AgencyManaguaNicaragua Department of Disease Prevention Ministry of Health in NicaraguaManaguaNicaragua

Background:Chagas disease is one of the neglected tropical diseases(NTDs).International goals for its control involve elimination of vector-borne *** American countries face challenges in establishing sustainable vector control programmes,since the main vector,Triatoma dimidiata,cannot be *** 2012,the Ministry of Health in Nicaragua started a field test of a vector surveillance-response system to control domestic vector *** paper reports the main findings from this pilot ***:This study was carried out from 2012 to 2015 in the Municipality of *** Japan International Cooperation Agency provided technical cooperation in designing and monitoring the surveillance-response system until *** system involved 1)vector reports by householders to health facilities,2)data analysis and planning of responses at the municipal health centre and 3)house visits or insecticide spraying by health personnel as a *** registered all vector reports and responses in a digital *** collected data were used to describe and analyse the system performance in terms of amount of vector reports as well as rates and timeliness of ***:During the study period,*** was reported 396 *** analysis identified some high-risk *** houses reported to be infested were visited by health personnel in 2013 and this response rate dropped to 39%in *** of insecticide spraying rose above 80%in 2013 but no spraying was carried out in the following 2 *** timeliness of house visits improved significantly after the responsibility was transferred from a vector control technician to primary health care ***:We argue that the proposed vector surveillance-response system is workable within the resourceconstrained health system in *** to the primary health care services was a key to improve the system *** efforts are necessary to keep adap

关键词： Chagas disease Triatoma dimidiata Vector control Surveillance-response system Programme integration Nicaragua

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