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Liver transplantation as an alternative for the treatment of perihilar cholangiocarcinoma: A critical review

Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 139-145页

作者： Wellington Andraus Francisco Tustumi Alexandre chagas Santana Rafael Soares Nunes Pinheiro daniel Reis Waisberg Liliana Ducatti Lopes Rubens Macedo Arantes Vinicius Rocha Santos Rodrigo Bronze de Martino Luiz Augusto carneiro D’Albuquerque Department of Gastroenterology Transplantation UnitUniversidade de São PauloSão PauloBrazil

Background:Perihilar cholangiocarcinoma(phccc)is a dismal *** is no consensus regard-ing the best treatment for patients with unresectable *** present review aimed to gather the current pieces of evidence for liver transplantation and liver resection as a treatment for phccc and to build better guidance for clinical *** sources:The search was conducted in PubMed,Embase,cochrane,and *** related references were searched *** criteria were:reports in English or Portuguese literature that a)patients with confirmed diagnosis of phccc;b)patients treated with a curative intent;c)patients with the outcomes of liver resection and liver *** reports,reviews,letters,editorials,conference abstracts and papers with full-text unavailability were excluded from the ***:Most of the current literature is based on observational retrospective studies with low grades of *** resection has better long-term outcomes than systemic chemotherapy or palliation ther-apy and liver transplantation is a good alternative for selected patients with unresectable *** candidates for resection or transplantation should be medically fit and free of intrahepatic or extrahep-atic *** a general rule,patients presenting with a tumor having a longitudinal size>3 cm or extending below the cystic duct,lymph node disease,confirmed extrahepatic dissemination;intraoper-atively diagnosed metastatic disease;a history of other malignancies within the last five years,and did not complete chemoradiation regimen and were medically unfit should not be considered for *** of these criteria should be individually *** transplantation or resection should only be considered in highly experienced hepatobiliary centers,and any decision-making must be based on a multidisciplinary ***:phccc is a complex condition with high *** therapies,including hepatec-tomy and liv

关键词： Liver transplantation cholangiocarcinoma Liver neoplasms

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Surgical Management of Perforated colon Tumours in Yaoundé: A Multicentre Retrospective Review of 30-Day Postoperative Outcome

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Surgical Science 2024年第5期15卷 330-341页

作者： Eric Patrick Savom Richard II Mbele colman Tamboh Tankou Mahamat Yannick Ekani Boukar cédric Paterson Atangana Fred Dikongue Dikongue daniel Biwole Biwole Guy Aristide Bang Arthur Essomba Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences University of Yaound&#233 I Yaound&#233 Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Dschang Dschang Cameroon Yaoundé Central Hospital Yaound&#233 Cameroon Yaoundé University Teaching Hospital Yaound&#233 Cameroon

Introduction: colon cancer is often diagnosed late in our context and there is a high prevalence of complicated forms, this including perforation. The optimal surgical treatment remains controversial. The aim of this study was to improve the short-term postoperative outcomes of patients operated upon for perforated colon cancer, by identifying factors associated with complications occurring within 30 days after surgery. Patients and methods: We carried out an analytical observational study, with a retrospective collection of data from the files of patients operated upon for an in situ tumoral colon perforation. This was done in four referral hospitals in the city of Yaoundé. The period was from the 1st of January, 2012 to the 31st of December, 2021. cox regression identified the factors associated with postoperative morbidity and mortality. Results: We collected files of 46 patients. The mean age was 54.7 ± 19.9 years with a sex ratio of 1.4. The clinical presentation on admission was dominated by the presence of signs of peritoneal irritation (91.3%) and bowel obstruction (28.3%). The diagnosis was made preoperatively in 16 cases (34.8%). The surgical procedures consisted of colectomy with anastomosis in 28 cases (60.9%) and without anastomosis in 14 cases (30.4%). Postoperative morbidity was 60.9% dominated by surgical site infection (37%). Postoperative mortality was 39.1%. The existence of generalized peritonitis was associated with the occurrence of postoperative complications (p = 0.019). The main factors associated with postoperative mortality were resection with primary anastomosis (p = 0.027), enterocutaneous fistula (p = 0.005). conclusion: colic resection with primary anastomosis or ideal colectomy is associated with an increased risk of mortality and should therefore not be performed in this setting.

关键词： Perforated colon cancer Postoperative Morbidity and Mortality colectomy Acute Generalized Peritonitis

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Laparoscopic Surgery of Incisional Hernia: Technique and Short-Term Results in Three Surgical Units in cameroon

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Surgical Science 2024年第4期15卷 232-243页

作者： Guy Aristide Bang Eric Patrick Savom Achille Aimé Bekolo Otiti Fred Dikongue Dikongue Mahamat Yannick Ekani Boukar Richard II Mbele cédric Paterson Atangana daniel Biwole Biwole Arthur Essomba Yaoundé Teaching Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Yaoundé I Yaound&#233 Cameroon Yaoundé General Hospital Yaound&#233 Cameroon Faculty of Medicine and Biomedical Sciences of the University of Dschang Dschang Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Yaoundé Central Hospital Yaound&#233 Cameroon

Introduction: Incisional hernia is a common medical situation and its treatment has always been a challenge for general surgeons. If laparoscopic repair has become a gold standard elsewhere, it is increasingly done in our milieu, but no data has been found. The aim of this study was to review this surgery done in our country so far, to describe the operative technique and to evaluate the postoperative outcomes. Patients and Methods: We conducted an observational descriptive study with retrospective collection of data from the 1st of July 2018 to 30th of June 2022, in three hospitals in cameroon. Data on socio-demographic and clinical characteristics, surgical technique and postoperative outcomes of patients who had a laparoscopic repair of their incisional hernia were collected. Results: We reviewed 20 files. There were 14 women with an average age of 54.6 years. The average BMI was 32.8 kg/m2. Thirteen patients had a moderate size hernia and the hernia was localized at the midline in 18 cases. Only composite biface meshes were used with dimensions chosen to obtain at least 5 cm overlap. Spiral tacks were the only fixation means used. We registered 3 complications. One case of generalized peritonitis secondary to missed digestive perforation, one case of seroma and one case of postoperative ileus. We registered no death. conclusion: Laparoscopic repair of incisional hernias is feasible in a resource-limited setting like ours. compliance with the operative technique and recommendations is important to obtain short-term results closed to that put forward by literature.

关键词： Incisional Hernia Laparoscopy Repair composite Biface Mesh Postoperative Outcomes

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Envita’s Precision cancer care: 35-Fold Improvement in Response Rates

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Journal of cancer Therapy 2024年第4期15卷 99-120页

作者： Sheba Goklany John c. Oertle III Ronald Matthias Jr. daniel Warren David Medina Rory Sears Robert Zieve Kendra Quart christopher Aussems Jon Moma Shannon Miller Zach Poteet conner coffin courtney Middleton Erika Ware Phylicia Zarnosky Julie Nowak Winlove Suasin daniel conway chad Burk Ruth Tan-Lim Dino Prato Envita Medical centers Scottsdale AZ USA

New clinical approaches are imperative beyond the widely adopted National comprehensive cancer Network (NccN) guidelines, utilized by prominent cancer institutions. cancer is the leading cause of death among individuals younger than 85 years within the United States. Despite significant technological advances, including the expenditure of hundreds of billions, treatment outcomes and overall survival have not notably improved for most types of advanced cancer over the last several decades. Over the past 24 years, Envita Medical centers has pioneered a unique form of personalized treatment approach for late-stage and refractory cancer patients, introducing groundbreaking innovations in the field. Our integrated algorithm utilizes advanced genomics, transcriptomics, and highly tailored immunotherapy, resulting in remarkable outcome improvements. This study presents Envita’s innovative personalized treatment algorithms and examines the response outcomes of 199 late-stage cancer patients treated at Envita Medical centers over a two-year period. compared to standard of care and palliative chemotherapy, Envita’s treatment demonstrated a remarkable 35-fold improvement in overall response rates (Figure 1). Moreover, 88% of the patients, the majority presenting with Stage 3 or 4 cancer, experienced a 43-fold improvement in quality of life with minimal side effects, as compared to standard of care chemotherapy and palliative care. This revolutionary success is attributed to Envita’s personalized therapeutic algorithms, which incorporate customized immunotherapy. Envita’s precision care approach has also achieved a 100% better response rate compared to over 65 global chemotherapy clinical trials with more than 2700 patients. The results from this study suggest that a wider utilization of Envita’s personalized approach can significantly benefit patients with late-stage and refractory cancer.

关键词： Envita Medical centers Late-stage cancer Overall Response Rate Quality of Life circulating Tumor cells (cTcs) Mutant Allele Frequency (MAF) Precision care

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Experimental model for the description of the behaviour of a 9-mm projectile at a target

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Forensic Sciences Research 2021年第1期6卷 67-74页

作者： Patricia Morales-Vega daniel Esteban Jaramillo-Arango Jaime Alberto osorio-Velez David Norena-Blandon Instituto de Fısica Universidad de AntioquiaMedellınColombia

Analysis of crime scenes involving single-fire-gun projectiles requires the determination of the direction of arrival of a projectile at the target and other factors to reconstruct *** movement of a projectile can be analyzed by applying Euler’s equations to a solid symmetrical rigid *** present work starts from a Newtonian reformulation of these equations to show that,in the presence of a gravitational field,the system can be expressed with a complex variable nonlinear equation,where the inclusion of small nutation variables allows us to find possible *** a particular case,we analyzed the movement of a 9-mm projectile fired from distances greater than 1 m to demonstrate that the direction of arrival of the projectile at the target cannot be traced by a stick placed in the target hole,as is usually performed in crime investigations.A series of shots were fired from distances varying between 1 m and 7 *** data were recorded on Riemann planes of projection for the description of nutation and precession motions,allowing the observation of the motion dynamics of the *** show that the direction of arrival at the target can be determined approximately from the analysis of the nutation and precession curves through Riemann planes of *** results presented in this work will allow more accurate judgements to be made in judicial investigations.

关键词： Forensic sciences forensic ballistics firearm gyroscopic motion Euler equations nutation precession projectile motion

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Early-onset colorectal cancer:A separate subset of colorectal cancer

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World Journal of Gastroenterology 2014年第46期20卷 17288-17296页

作者： Irene osorio Silla daniel Rueda Yolanda Rodríguez Juan Luis García Felipe de la cruz Vigo José Perea Department of Surgery 12 de Octubre University HospitalMadrid 28041Spain Molecular Biology Laboratory 12 de Octubre University HospitalMadrid 28041Spain Department of Pathology 12 de Octubre University HospitalMadrid 28041Spain centre for cancer Research Medical University of SalamancaSalamanca 37008Spain

colorectal cancer(cRc)has a great impact on the world *** increasing frequency,cRc is described according to the presenting phenotype,based on its molecular *** of cRc tumors according to their genetic and/or epigenetic alterations is not only important for establishing the molecular bases of the disease,but also for predicting patient outcomes and developing more individualized ***-onset cRc is a heterogeneous disease,with a strong familial component,although the disease is sporadic in an important proportion of *** molecular alterations appear to contribute to the apparent heterogeneity of the early-onset population and subgroups can be distinguished with distinct histopathologic and familial ***,compared with late-onset cRc,there are characteristicsthat suggest that early-onset cRc may have a different molecular *** purpose of this review was to analyze the current state of knowledge about earlyonset cRc with respect to clinicopathologic,familial and molecular ***,these features make it increasingly clear that this subset of cRc may be a separate disease,although it has much in common with late-onset cRc.

关键词： chromosomal instability cpG island methylator phenotype Early-onset colorectal cancer Lynch syndrome Microsatellite instability

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Numerical Models and Methods of Atmospheric Parameters Originating in the Formation of the Earth’s climatic cycle

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Atmospheric and climate Sciences 2024年第2期14卷 277-286页

作者： Wend Dolean Arsène Ilboudo Kassoum Yamba Windé Nongué daniel Koumbem Issaka Ouédraogo Dé partement Energie Institut de Recherche en Sciences Appliqu&#233es et Technologies (IRSAT) Ouagadougou Burkina Faso Unité de Formation et de Recherche en Sciences Exactes et Appliqu&#233es Universit&#233 Joseph KI-ZERBO Ouagadougou Burkina Faso

Atmospheric models are physical equations based on the ideal gas law. Applied to the atmosphere, this law yields equations for water, vapor (gas), ice, air, humidity, dryness, fire, and heat, thus defining the model of key atmospheric parameters. The distribution of these parameters across the entire planet Earth is the origin of the formation of the climatic cycle, which is a normal climatic variation. To do this, the Earth is divided into eight (8) parts according to the number of key parameters to be defined in a physical representation of the model. Following this distribution, numerical models calculate the constants for the formation of water, vapor, ice, dryness, thermal energy (fire), heat, air, and humidity. These models vary in complexity depending on the indirect trigonometric direction and simplicity in the sum of neighboring models. Note that the constants obtained from the equations yield 275.156˚K (2.006˚c) for water, 273.1596˚K (0.00963˚c) for vapor, 273.1633˚K (0.0133˚c) for ice, 0.00365 in/s for atmospheric dryness, 1.996 in2/s for humidity, 2.993 in2/s for air, 1 J for thermal energy of fire, and 0.9963 J for heat. In summary, this study aims to define the main parameters and natural phenomena contributing to the modification of planetary climate. .

关键词： Atmospheric Parameter 1 climatic cycle 2 Numerical Models 3

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capturing cO2 Emissions in the George c. Wallace Tunnel: A case Study

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Intelligent control and Automation 2024年第3期15卷 83-94页

作者： Gabe canitz cole ciesta Klint Green Justin Sanders Jason Valencia Jeremy Willingham daniel Fonseca Department of Mechanical Engineering The University of Alabama Tuscaloosa AL USA

This paper describes the design of a ventilation system to be paired with a carbon capture system. The ventilation system utilizes the geometry of the George c. Wallace tunnel, located in the city of Mobile, Alabama, USA to capture and redirect emissions to a direct air capture (DAc) device to sequester 25% of the total cO2 mass generated from inside the tunnel. The total cO2 mass rate for the westbound traffic between the week-day hours of 7 a.m. and 6 p.m. has been estimated between 2,300 to 3,000 lbs./hr. By sequestering these emissions, the overall surrounding air quality was shown to be improved to a level that mirrors that from the pre-US industrial era of 270 ppm.

关键词： cO2 capture Tunnel Ventilation Air Flow Analysis Jet Fan Sizing

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A Long-Range Generalized Predictive control Algorithm for a DFIG Based Wind Energy System

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IEEE/cAA Journal of Automatica Sinica 2019年第5期6卷 1209-1219页

作者： J.S.Solis-chaves Lucas L.Rodrigues c.M.Rocha-osorio Alfeu J.Sguarezi Filho the Department of Energy Engineering at the Federal University of ABc-UFABc Santo AndreSPBrazil

This paper presents a new Long-range generalized predictive controller in the synchronous reference frame for a wind energy system doubly-fed induction generator based. This controller uses the state space equations that consider the rotor current and voltage as state and control variables, to execute the predictive control action. Therefore, the model of the plant must be transformed into two discrete transference functions, by means of an auto-regressive moving average model, in order to attain a discrete and decoupled controller, which makes it possible to treat it as two independent single-input single-output systems instead of a magnetic coupled multiple-input multiple-output system. For achieving that, a direct power control strategy is used, based on the past and future rotor currents and voltages estimation. The algorithm evaluates the rotor current predictors for a defined prediction horizon and computes the new rotor voltages that must be injected to controlling the stator active and reactive powers. To evaluate the controller performance, some simulations were made using Matlab/Simulink. Experimental tests were carried out with a small-scale prototype assuming normal operating conditions with constant and variable wind speed profiles. Finally, some conclusions respect to the dynamic performance of this new controller are summarized.

关键词： Direct power control doubly-fed induction generator flux oriented control generalized predictive control long-range predictive control wind energy systems

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Evolution of heart transplant donor characteristics in the 21st century: A United States single center’s experience

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World Journal of Transplantation 2024年第3期14卷 22-29页

作者： Alexander M Spring christiana Gjelaj Shivank Madan Snehal R Patel Omar Saeed Sandhya Murthy Yogita Rochlani daniel B Sims Sasha Vukelic Stephen J Forest Jamil F Borgi daniel J Goldstein Ulrich P Jorde Montefiore-Einstein center for Heart and Vascular care Montefiore Medical CenterAlbert Einstein College of MedicineBronxNY 10467United States Division of cardiothoracic Surgery Tulane UniversityNew OrleansLA 70112United States

Despite a record setting number of heart transplants performed annually,the national donor shortage continues to plague transplant teams across the United *** we describe the barriers to adaptation of numerous“non-traditional”orthotopic heart transplant donor characteristics including donors with hepatitis c virus,those meeting criteria for donation after cardiac death,donors with coronavirus disease 19 infection,donors with the human immunodeficiency virus,and grafts with left ventricular systolic *** center’s objective was to increase our transplant volume by expanding our donor pool from“traditional”donors to these“non-traditional”*** detail how medical advances such as certain laboratory studies,pharmacologic interventions,and organ care systems have allowed our center to expand the donor pool thereby increasing transplantation volume without adverse effects on outcomes.

关键词： Orthotopic heart transplantation Hepatitis c virus cOVID-19 Left ventricular systolic dysfunction Human immunodeficiency virus Donation after cardiac death

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