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Clinical and socioeconomic determinants of survival in biliary tract adenocarcinomas

World Journal of Gastrointestinal Oncology 2024年第4期16卷 1374-1383页

作者： Laura Sahyoun Kay Chen cynthia Tsay George Chen Petr Protiva Department of Gastroenterology and Hepatology Weill Cornell MedicineNew YorkNY 10065United States Gastroenterology Section Jennifer Moreno VA San Diego Healthcare SystemSan DiegoCA 92161United States Division of Gastroenterology Department of MedicineUniversity of California San DiegoLa JollaCA 92093United States Department of Gastroenterology and Hepatology John Hopkins HospitalBaltimoreMD 21287United States Department of Digestive Diseases Yale New Haven HospitalNew HavenCT 06520United States Department of Gastroenterology VA Connecticut Health Care SystemWest HavenCT 06516United States

BACKGROUND Despite advances in detection and treatments,biliary tract cancers continue to have poor survival ***,there is limited data investigating the significance of socioeconomic status,race/ethnicity,and environmental factors in biliary tract cancer *** from the Surveillance,Epidemiology,and End Results database for biliary and gallbladder adenocarcinomas were extracted from 1975 to ***-conomic data included smoking,poverty level,education,adjusted household income,and percentage of foreign-born persons and urban *** was calculated with Cox proportional hazards models for death in the 5-year period following *** Our study included 15883 gallbladder,11466 intrahepatic biliary,12869 extrahepatic biliary and 7268 ampulla of Vater adenocarcinoma *** analyzing county-specific demographics,patients from counties with higher incomes were associated with higher survival rates[hazard ratio(HR)=0.97,P<0.05].Similarly,counties with a higher percentage of patients with a college level education and counties with a higher urban population had higher 5-year survival rates(HR=0.96,P=0.002 and HR=0.97,P=0.004,respectively).CONCLUSION Worse survival outcomes were observed in lower income counties while higher income and education level were associated with higher 5-year overall survival among gallbladder and biliary malignancies.

关键词： Biliary tract cancers Survival Outcomes research Socioeconomic factors Healthcare disparities

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儿童健康优先和干预措施

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英国医学杂志中文版 2017年第17期20卷 190-196页

作者： Wilson M Were Zulfiqar A Bhutta Trevor Duke Rajiv Bahl cynthia boschi-pinto Mark Young Eric Starbuck Maharaj K Bhan 熊祎杜忠东 Department of Maternal NewbornChild and Adolescent Health World Health Organization GenevaSwitzerland Center for GlobalChild Health Hospital for Sick Children TorontoON Canada Center of Excellencein Women and Child Health Aga KhanUniversity KarachiPakistan Centre forInternational Child Health Department of PaediatricsUniversity of MelbourneMelbourne VICAustralia Health Section United Nations Children Fund(UNICEF) New York NY USA Department of Global Health Save the Children Fairfield CT USA Indian Institute of Technology New Delhi India 首都医科大学附属北京儿童医院

Wilson Were和他的同事解释了为什么全球社会应该继续投资于儿童健康，完成尚未完成的儿童生存议程，解决新出现的影响儿童健康的优先问题。

关键词：儿童健康优先干预措施保健知识

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Impact of an oligosaccharide-based polymer on the metabolic profiles and microbial ecology of weanling pigs experimentally infected with a pathogenic ***

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Journal of Animal Science and Biotechnology 2024年第2期15卷 749-764页

作者： Kwangwook Kim cynthia Jinno Xunde Li David Bravo Eric Cox Peng Ji Yanhong Liu Department of Animal Science University of CaliforniaDavisCA 95616USA Department of Animal Science Michigan State UniversityEast LansingMI 48824USA Cedars-Sinai Medical Center Los AngelesCA 90084USA School of Veterinary Medicine University of CaliforniaDavisCA 95616USA Pancosma|ADM 1180 RolleSwitzerland Nutreco Exploration NutrecoThe Netherlands Department of Virology Parasitology and ImmunologyGhent University9000 GhentBelgium Department of Nutrition University of CaliforniaDavisCA 95616USA

Background Our previous study has reported that supplementation of oligosaccharide-based polymer enhances gut health and disease resistance of pigs infected with enterotoxigenic ***(ETEC)F18 in a manner similar to *** objective of this study was to investigate the impacts of oligosaccharide-based polymer or antibiotic on the host metabolic profiles and colon microbiota of weaned pigs experimentally infected with ETEC *** Multivariate analysis highlighted the differences in the metabolic profiles of serum and colon digesta which were predominantly found between pigs supplemented with oligosaccharide-based polymer and *** relative abundance of metabolic markers of immune responses and nutrient metabolisms,such as amino acids and carbohydrates,were significantly differentiated between the oligosaccharide-based polymer and antibiotic groups(q2.0).In addition,pigs in antibiotic had a reduced(P<0.05)relative abundance of Lachnospiraceae and Lactobacillaceae,whereas had greater(P<0.05)Clostridiaceae and Streptococcaceae in the colon digesta on d 11 post-inoculation(PI)compared with d 5 *** The impact of oligosaccharide-based polymer on the metabolic and microbial profiles of pigs is not fully understood,and further exploration is ***,current research suggest that various mechanisms are involved in the enhanced disease resistance and performance in ETEC-challenged pigs by supplementing this polymer.

关键词： Carbadox Colon microbiota Enterotoxigenic E.coli F18 Metabolomics Oligosaccharide-based polymer Weaned pigs

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Abomasal infusion of branched-chain amino acids or branched-chain keto-acids alter lactation performance and liver triglycerides in fresh cows

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Journal of Animal Science and Biotechnology 2024年第3期15卷 1145-1157页

作者： Kristen Gallagher Isabelle Bernstein cynthia Collings David Main Ghayyoor Ahmad Sarah Naughton Jayasimha Daddam Vengai Mavangira Mike Vandehaar Zheng Zhou Department of Animal Science Michigan State UniversityEast Lansing 48824USA Department of Veterinary Diagnostic and Production Animal Medicine Ames 50011USA

Background Dairy cows are at high risk of fatty liver disease in early lactation,but current preventative measures are not always *** with fatty liver have lower circulating branched-chain amino acid(BCAA)concentra-tions whereas cows with high circulating BCAA levels have low liver triglyceride(TG).Our objective was to determine the impact of BCAA and their corresponding ketoacids(branched-chain ketoacids,BCKA)on production performance and liver TG accumulation in Holstein cows in the first 3 weeks *** Thirty-six multiparous Holstein cows were used in a randomized block design *** were abomasally infused for the first 21 d postpartum with solutions of 1)saline(CON,n=12);2)BCA(67 g valine,50 g leu-cine,and 34 g isoleucine,n=12);and 3)BCK(77 g 2-ketovaline calcium salt,57 g 2-ketoleucine calcium salt,and 39 g 2-ketoisoleucine calcium salt,n=12).All cows received the same *** effects were determined using PROC GLIMMIX in *** No differences were detected for body weight,body condition score,or dry matter intake averaged over the first 21 d *** receiving BCK had significantly lower liver TG concentrations compared to CON(6.60%vs.4.77%,standard error of the mean(SEM)0.49)during the first 3 weeks of *** of BCA increased milk yield(39.5 vs.35.3 kg/d,SEM 1.8),milk fat yield(2.10 vs.1.69 kg/d,SEM 0.08),and lactose yield(2.11 vs.1.67 kg/d,SEM 0.07)compared with *** to CON,cows receiving BCA had lower plasma glucose(55.0 vs.59.2 mg/dL,SEM 0.86)but higherβ-hydroxybutyrate(9.17 vs.6.00 mg/dL,SEM 0.80).Conclusions Overall,BCAA supplementation in this study improved milk production,whereas BCKA supplementa-tion reduced TG accumulation in the liver of fresh cows.

关键词： Branched-chain amino acids Branched-chain ketoacids Fatty liver Fresh cow

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Advancing Pediatric Hemodialysis Care through the Novel Intervention in Children’s Healthcare (NICH) Program

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Open Journal of Nephrology 2024年第3期14卷 295-301页

作者： Jessica Williams Natalia Garban cynthia Wong Elizabeth Talley Department of Pediatric Nephrology Lucille Packard Childrens Hospital Stanford Palo Alto USA NICH Program Care Team Lucille Packard Childrens Hospital Stanford Palo Alto USA

Racial, ethnic, and socioeconomic disparities present daunting hurdles that prevent equitable health outcomes for patients with end-stage kidney disease (ESKD) on hemodialysis. Additional resources, such as the Novel Intervention in Children’s Health (NICH) at Lucille Packard Children’s Hospital Stanford, provide individualized support to best assist families by assessing barriers to care with the goal of improving health outcomes. In this retrospective cohort study, we reviewed patients with ESKD on hemodialysis involved in NICH to explore if NICH serves as a liaison between the patients and multidisciplinary medical team and to explore if NICH helps patients better manage the challenges of end-stage kidney disease. Through the electronic medical record system, EPIC, we reviewed the patients’ surveys to identify barriers to care, which included school and life engagement difficulty, lack of mental health resources, food and transportation insecurity, and cultural/language barriers. We also tracked the number of hospitalizations and ED visits before and during the patients’ enrollment in NICH. We discovered that through NICH, the aforementioned barriers to care were eliminated, the number of hospitalizations and emergency department visits was reduced, and all patients transitioned from inactive to active on the transplant list. NICH successfully improved the health outcomes of these patients and empowered patients to be more engaged in their care.

关键词： Pediatric Hemodialysis ESKD NICH Healthcare Disparities

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Psychiatric comorbidities in children with conduct disorder:a descriptive analysis of real-world data

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General Psychiatry 2024年第2期37卷 301-305页

作者： Tashalee R Brown Anita S Kablinger Robert Trestman Eraka Bath cynthia Rogers Binx Yezhe Lin Kevin Young Xu University of California Los Angeles David Geffen School of Medicine Los AngelesCaliforniaUSA Department of Psychiatry and Behavioral Medicine Virginia Tech Carilion School of MedicineRoanokeVirginiaUSA Washington University in St Louis School of Medicine St LouisMissouriUSA Clinical Research Center for Mental Disorders Chinese-German Institute of Mental HealthShanghai Pudong New Area Mental Health CenterSchool of MedicineTongji UniversityShanghaiChina Department of Psychosomatic Medicine Shanghai East HospitalTongji University School of MedicineShanghaiChina Department of Psychiatry Washington University School of Medicine in Saint LouisSt LouisMissouriUSA

To the editor:Two recent advisories from the US surgeon general have underscored the unprecedented public health crisis in youth mental health and emphasised the need for“timely data collection and research to identify and respond to youth mental health needs more rapidly”.1 Increased rates of suicidal behaviour,depression and anxiety symptoms and substance use.

关键词： morbid Psychiat editor

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Assessing Human-Wildlife Conflict in the Periphery of Loango National Park in Gabon

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Open Journal of Forestry 2024年第3期14卷 297-312页

作者： Mbani cynthia Axelle Eugénie N’Safou Abubakar Ali Shidiki Ngankam Martin Tchamba Department of Forestry The University of Dschang Dschang Cameroon

Human-Wildlife Conflict in Gabon is a reality occurring in almost all protected areas in the country. These conflicts create real threats both for the survival of wildlife species and of human beings. This study was carried out at the periphery of Loango National Park in Gabon. This area is particular of seeing elephants wandering around villages. Respondents for the study were drawn from a wide range of stakeholders (State administrators, farmers and NGOs). Data was collected through administration of structured questionnaires and interview guide on the;socio-economic activities. Crops produced/destroyed. Animals are involved and economic loss is incurred due to conflicts. Data was analysed using SPSS version 16 and Kobo tool box. For qualitative data chi-square, descriptive statistic and linear regression model were also used. The results of the study showed that the elephants account for (60.1%) of crop destroyed followed by Ungulates (30.4%) and lastly by rodents (0.9%). The economic damage caused by the wildlife to crops valued at 72,084 USD in the zone in 2022. An urgent solution to this conflict is needed because the consequences are visible as well as the illegal repression by communities that have led to poisoning and killing of wildlife in the study area.

关键词： Human-Wildlife Conflict Protected Areas Crop Damage Crop Losses Loango National Park

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Artificial Neural Network and Fuzzy Logic Based Techniques for Numerical Modeling and Prediction of Aluminum-5%Magnesium Alloy Doped with REM Neodymium

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International Journal of Nonferrous Metallurgy 2024年第1期11卷 1-19页

作者： Anukwonke Maxwell Chukwuma Chibueze Ikechukwu Godwills cynthia C. Nwaeju Osakwe Francis Onyemachi Department of Metallurgical and Materials Engineering Nnamdi Azikiwe University Awka Nigeria Department of Mechanical Engineering Nigeria Martine University Okerenkoko Nigeria

In this study, the mechanical properties of aluminum-5%magnesium doped with rare earth metal neodymium were evaluated. Fuzzy logic (FL) and artificial neural network (ANN) were used to model the mechanical properties of aluminum-5%magnesium (0-0.9 wt%) neodymium. The single input (SI) to the fuzzy logic and artificial neural network models was the percentage weight of neodymium, while the multiple outputs (MO) were average grain size, ultimate tensile strength, yield strength elongation and hardness. The fuzzy logic-based model showed more accurate prediction than the artificial neutral network-based model in terms of the correlation coefficient values (R).

关键词： Al-5%Mg Alloy Neodymium Artificial Neural Network Fuzzy Logic Average Grain Size and Mechanical Properties

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Item-Level Analysis of the Revised Occupational Therapy Fieldwork Performance Evaluation Applied in Practice

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Open Journal of Therapy and Rehabilitation 2024年第2期12卷 145-159页

作者： cynthia L. Sears Brad E. Egan Patricia F. Tomsic Craig A. Velozo Graduate College of Health Professions Occupational Therapy Program Hawai&#8217i Pacific University Honolulu HI USA College of Science and Health Occupational Therapy Program DePaul University Chicago IL USA Department of Occupational Therapy Wingate University Wingate NC USA College of Health Professions Department of Rehabilitation Sciences Division of Occupational Therapy Medical University of South Carolina Charleston SC USA

Competency-based assessments for healthcare professionals are critical for safe and effective client outcomes. Rehabilitation clinical skill competency assessments must be validated and revised to produce safe and skilled practitioners. The revised American Occupational Therapy Association (AOTA) Fieldwork Performance Evaluation (FWPE) instrument measures occupational therapy student performance to determine readiness for practice. The assessment includes thirty-seven competencies that address both profession specific clinical skills and general professional behavior skills. The objective of this study was to use Rasch methods to explore the use of the revised FWPE in actual fieldwork practice and to determine the instrument’s psychometric properties when separating the item components into two distinct subdomains: General Health Professions Competences and Occupational Therapy-Specific Competencies. Internal construct validity and test reliability were analyzed using data from 149 occupational therapy students after completing their initial Level II A fieldwork clinical internship. This study examined the item difficulty hierarchy, item fit, person-fit to model, person separation index, person separation reliability coefficient, strata, ceiling and floor effect, and unidimensionality of the FWPE instrument as a whole and as two separate domains. With the exception of not meeting the criteria for unidimensionality, the full FWPE instrument and the Occupational Therapy-Specific Competencies subdomain showed acceptable item-level psychometrics for reliability and precision. While the General Health Professions Competencies subdomain showed good item-level psychometrics, it was below the criterion for reliability and only separated the sample into two strata. Results support the validity, reliability, and clinical use of the revised FWPE full instrument and the Occupational Therapy-Specific Competencies subdomain to measure entry-level clinical skill competencies in pr

关键词： Rehabilitation Competency-Based Assessments Occupational Therapy Measurement Rasch Analysis

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Osgood Schlatter Disease: Study of 2 Observations in Conakry, Guinea

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Open Journal of Rheumatology and Autoimmune Diseases 2024年第2期14卷 77-83页

作者： Adama Bah Laetitia cynthia Abandazegoue Andjembe Abdoulaye Barry Mamadou Lamine Diallo Moustapha Niasse Aly Badra Kamissoko Rheumatology Department Ignace Deen Hospital Conakry Conakry Guin&#233e Rheumatology Department CHU Aristide Le Dantec of Dakar Dakar S&#233n&#233gal Department of Rhumatology Sylvanus Olypio University Hospital Lom&#233 Lom&#233 Togo

Introduction: OSD is a growth osteochondrosis affecting the apophyseal cartilage of the anterior tibial tuberosity of the knee, 20 to 30% of young growing athletes suffer from this pathology, described by Osgood and Schlatter in 1903. Objective: To report 2 observations and review the literature. Observation 1: This was a 14-year-old Guinean teenager, Halpoular, living in Conakry, a right-handed footballer who presented with a painful swelling of the right knee that looked mechanical, whose father had HLA B27 positive ankylosing spondylitis. X-ray of the right knee showed fragmentation of the anterior tibial tuberosities, and ossicle with edema of the patellar tendons at stage 4 according to Ehrenbord and Lagergren (1961). Thus, the disease of OSD is retained, He received 120 mg of diclofenac, 20 mg omeprazole for 1 month and the cessation of sports activity, the evolution was favorably marked by the regression of pain. Observation 2: A 16-year-old girl, initials M.L.T, Guinean, residing in Coyah (Republic of Guinea), a handball player, consulted for intense pain (VAS: 8/10) in her knees after a violent shock received when she hit the post. The physical examination found a painful, soft swelling at the anterior tibial tuberosity of the right knee, the rest of the examination was normal. The X-ray of the right knee shows fragmentation of the anterior tibial tuberosity, and ossicle with edema of the patellar tendon at stage 4 according to Ehrenbord and Lagergren 1961, thus the OSD disease is retained, the treatment instituted was 120 mg of diclofenac, the cessation of sports activity which gives a good evolution (EVA at 2/10). Conclusion: OSD is a growth osteochondrosis affecting the apophyseal cartilage of the anterior tibial tuberosity of the knee in young growing athletes, resolving at rest.

关键词： Osgood Shlatter Disease Young Athlete

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