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critical appraisal of novel prediction models and risk calculators for post-hepatectomy liver failure and complications: practicability and generalisability in the real-world setting

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 696-698页

作者： darren Weiquan chua Yun Zhao Ye Xin Koh Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre SingaporeSingaporeSingapore Duke-National University of Singapore Medical School SingaporeSingapore Liver Transplant Service SingHealth Duke-National University of Singapore Transplant CentreSingaporeSingapore

Over the last few decades,the evolution of liver resection has progressed through numerous milestones in peri-operative management,operative techniques and novel technologies that have dramatically improved patient safety and outcomes(1).consequently,such developments have enabled surgeons to embark on liver resections of lesions in technically challenging locations,whereby extended resection or bilovascular reconstruction may be required to ensure oncologic *** the context of extended resections or resection of lesions from heavily diseased livers,concerns remain regarding the adequacy of the remnant future liver remnant(FLR)and liver function,placing patients at risk of the clinical phenomenon known as post-hepatectomy liver failure(PHLF).Although relatively uncommon,PHLF has a reported incidence of up to 32%in the literature and remains an important cause of post-hepatectomy morbidity and mortality(2).Presently,several definitions have been proposed to describe PHLF,the most recent of which was proposed by the International Study Group of Liver Surgery(ISGLS).In this definition,PHLF was defined as an increased international normalized ratio(INR)or hyperbilirubinemia on or after post-operative day 5,with further stratification of severity grades(A,B or c)based on the extent of clinical management(3).While definitions in PHLF assist in providing a common diagnostic framework among physicians,establishing predictors in PHLF is conceivably more helpful as it allows surgeons to have important decision-making details prior to planned liver resection.

关键词： Hepatectomy post-hepatectomy liver failure(PHLF) predictive model risk calculation

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Acetabular cup size trends in total hip arthroplasty

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World Journal of Orthopedics 2024年第1期15卷 39-44页

作者： Daniel Patrick McKenna Alex Price Timothy McAleese darren Dahly Paul McKenna May cleary Department of Trauma and Orthopaedics University Hospital WaterfordWaterford X91 ER8EIreland Department of Epidemiology and Public Health University College CorkCork T12 XF62Ireland

BAcKGROUND Total hip arthroplasty(THA)is a common procedure for end stage *** learning curve for THA is complex and *** of the most difficult skills to master is acetabular *** wish to identify if experience in arthroplasty leads to preservation of more bone *** To investigate if increasing surgeon experience will predict an ever decreasing acetabular cup *** A retrospective case series of four attending orthopaedic surgeons was *** uncemented elective total hip arthroplasties since appointment were selected for *** size of acetabular cup used was noted and logistic regression was used to identify if a trend to smaller cups *** A total of 1614 subjects were included with a mean age of 64 *** cups were on average 0.18mm smaller per year(95%confidence interval-0.25 to-0.11,Pcup sizes to decrease 0.27 mm/year for surgeon A,0.02 mm/year for surgeon B,0.15 mm/year for surgeon c and 0.29 mm/year for surgeon *** of the four surgeons had a more pronounced trend to smaller cups for male subjects than their female *** We found increasing surgeon experience to be associated with an ever-decreasing acetabular cup *** acetabular cup size may act as a surrogate marker of surgical proficiency by virtue of decreased acetabular reaming.

关键词： Hip Arthroplasty Acetabulum cup Learning

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加强对肥胖的初级预防:群体随机试验

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英国医学杂志中文版 2004年第2期7卷 127-127页

作者： Helen Moore carolyn D Summerbell darren c greenwood Philip Tovey Jacqui Griffiths Maureen Henderson Kate Hesketh Sally Woolgar Ashley J Adamson 顾佳

目的:对一个面向全科医师,旨在加强肥胖初级预防的培训项目进行评估。设计:群体随机试验。地点:英格兰北部及约克郡地区。

关键词：肥胖初级预防试验生活方式

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Subordinacy theory for extended cMV matrices

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Science china Mathematics 2022年第3期65卷 539-558页

作者： Shuzheng Guo David Damanik darren c.Ong School of Mathematical Sciences Ocean University of ChinaQingdao 266100China Department of Mathematics Rice UniversityHoustonTX 77005USA Department of Mathematics Xiamen University MalaysiaSepangSelangor Darul Ehsan 43900Malaysia

We develop subordinacy theory for extended cantero-Moral-Velázquez(cMV) matrices,i.e.,we provide explicit supports for the singular and absolutely continuous parts of the canonical spectral measure associated with a given extended cMV matrix in terms of the presence or absence of subordinate solutions to the generalized eigenvalue *** corollaries and applications of this result are described as well.

关键词： spectral theory subordinacy theory cMV matrix unitary operator carathéodory function

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Statin, aspirin and metformin use and risk of hepatocellular carcinoma related outcomes following liver transplantation: A retrospective study

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World Journal of Transplantation 2024年第3期14卷 120-131页

作者： William chung Kevin Wong Noel Ravindranayagam Lauren Tang Josephine Grace darren Wong Danny con Marie Sinclair Avik Majumdar Numan Kutaiba Samuel Hui Paul Gow Vijayaragavan Muralidharan Alexander Dobrovic Adam Testro Department of Gastroenterology Austin HealthHeidelberg 3084VictoriaAustralia Victorian Liver Transplant Unit Austin HealthHeidelberg 3084VictoriaAustralia Department of Radiology Austin HealthHeidelberg 3084VictoriaAustralia Department of Gastroenterology Monash HealthClayton 3168VictoriaAustralia Department of Surgery University of MelbourneAustin HealthHeidelberg 3048VictoriaAustralia Department of Surgery Beacon LaboratoryAustin PrecinctThe University of MelbourneAustin HospitalHeidelberg 3048VictoriaAustralia

BAcKGROUND Liver transplantation(LT)is a potentially curative therapy for patients with hepatocellular carcinoma(Hcc).Hcc-recurrence following LT is associated with reduced *** is increasing interest in chemoprophylaxis to improve Hcc-related outcomes *** To investigate whether there is any benefit for the use of drugs with proposed chemoprophylactic properties against Hcc,and patient outcomes following *** This was a retrospective study of adult patients who received Deceased Donor LT for Hcc from 2005-2022,from a single Australian *** use was defined as statin,aspirin or metformin therapy for≥29 days,within 24 months post-LT.A cox proportional-hazards model with time-dependent covariates was used for survival *** measures were the composite-endpoint of Hcc-recurrence and all-cause mortality,Hcc-recurrence and Hcc-related *** analysis was performed to account for immortality time bias and statin *** Three hundred and five patients were included in this study,with 253(82.95%)males with a median age of 58.90 *** of liver disease were 150(49.18%)hepatitis c,73(23.93%)hepatitis B(HBV)and 33(10.82%)non-alcoholic fatty liver disease(NAFLD).56(18.36%)took statins,51(16.72%)aspirin and 50(16.39%)*** a median follow-up time of 59.90 months,34(11.15%)developed Hcc-recurrence,48(15.74%)died,17(5.57%)from Hcc-related ***,aspirin or metformin use was not associated with statistically significant differences in the composite endpoint of Hcc-recurrence or all-cause mortality[hazard ratio(HR):1.16,95%cI:0.58-2.30;HR:1.21,95%cI:0.28-5.27;HR:0.61,95%cI:0.27-1.36],Hcc-recurrence(HR:0.52,95%cI:0.20-1.35;HR:0.51,95%cI:0.14-1.93;HR 1.00,95%cI:0.37-2.72),or Hcc-related mortality(HR:0.32,95%cI:0.033-3.09;HR:0.71,95%cI:0.14-3.73;HR:1.57,95%cI:0.61-4.04)*** dosing was not associated with statist-ically significant differences in Hcc-related ***

关键词： Liver transplantation Hepatocellular carcinoma Transplant oncology Statins HMG-co-A reductase Aspirin Metformin Mammalian target of rapamycin

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Microenvironmental influences on T cell immunity in cancer and inflammation

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cellular & Molecular Immunology 2022年第3期19卷 316-326页

作者： darren R.Heintzman Emilie L.Fisher Jeffrey c.Rathmell Department of Pathology Microbiologyand ImmunologyVanderbilt University Medical CenterNashvilleTN37205USA Vanderbilt center for Immunobiology Vanderbilt University Medical CenterNashvilleTN37205USA

T cell metabolism is dynamic and highly *** the intrinsic metabolic programs of T cell subsets are integral to their distinct differentiation and functional patterns,the ability of cells to acquire nutrients and cope with hostile microenvironments can limit these pathways.T cells must function in a wide variety of tissue settings,and how T cells interpret these signals to maintain an appropriate metabolic program for their demands or if metabolic mechanisms of immune suppression restrain immunity is an area of growing *** in inflamed and cancer tissues,a wide range of changes in physical conditions and nutrient availability are now acknowledged to shape *** include fever and increased temperatures,depletion of critical micro and macro-nutrients,and accumulation of inhibitory waste *** we review several of these factors and how the tissue microenvironment both shapes and constrains immunity.

关键词： immunometabolism T cell microenvironment cancer inflammation

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Graph neural network modeling of grain-scale anisotropic elastic behavior using simulated and measured microscale data

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npj computational Materials 2022年第1期8卷 2471-2482页

作者： darren c.Pagan calvin R.Pash Austin R.Benson Matthew P.Kasemer Pennsylvania State University University ParkPA16802USA cornell University IthacaNY14853USA University of Alabama TuscaloosaAL35487USA

Here we assess the applicability of graph neural networks(GNNs)for predicting the grain-scale elastic response of polycrystalline metallic *** GNN surrogate models,grain-averaged stresses during uniaxial elastic tension in low solvus high-refractory(LSHR)Ni Superalloy and Ti 7 wt%Al(Ti-7Al)are predicted as example face-centered cubic and hexagonal closed packed alloys,respectively.A transfer learning approach is taken in which GNN surrogate models are trained using crystal elasticity finite element method(cEFEM)simulations and then the trained surrogate models are used to predict the mechanical response of microstructures measured using high-energy X-ray diffraction microscopy(HEDM).The performance of using various microstructural and micromechanical descriptors for input nodal features to the GNNs is explored through comparisons to traditional mean-field theory predictions,reserved full-field cEFEM data,and measured far-field HEDM *** effects of elastic anisotropy on GNN model performance and outlooks for the extension of the framework are discussed.

关键词： grain neural behavior

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Shifts in the Holstein dairy cow milk fat globule membrane proteome that occur during the first week of lactation are affected by parity

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Journal of Animal Science and Biotechnology 2021年第2期12卷 534-548页

作者： Mallory c.Honan Megan J.Fahey Amanda J.Fischer-Tlustos Michael A.Steele Sabrina L.greenwood Department of Animal and Veterinary Sciences The University of VermontBurlingtonVT 05405USA Department of Animal Biosciences University of GuelphGuelphON N1G 2W1Canada Department of Agriculture Food&Nutritional ScienceUniversity of AlbertaEdmontonAB T6G 2P5Canada

Background:The milk fat globule membrane(MFGM)proteomes of colostrum and transition milk are rich sources of proteins that are likely important for neonatal calf *** addition,characterization of these proteomes could also yield valuable information regarding mammary gland physiology of the early postpartum lactating *** objectives of this research were to characterize the MFGM proteomes of colostrum and transition milk through sample collections at four timepoints postpartum,including the first milking(M1,colostrum),second milking(M2,transition milk),fourth milking(M4,transition milk),and fourteenth milking(M14,mature milk),and compare these proteomes between multiparous(MP;n=10)and primiparous(PP;n=10)Holstein dairy *** MFGM proteins were labeled using Tandem Mass tagging and analyzed using liquid chromatography-tandem mass spectrometry(Lc-MS/MS).Protein identification was completed using MAScOT and Sequest in Proteome Discoverer *** scaled abundance values were analyzed using PROc MIXED in SAS to determine the effects of milking(MIL),parity(PAR),and MIL×*** adaptive false-discovery rate(FDR)-adjusted P values were determined using PROc *** characterization and bioinformatic analysis were completed using a combination of PANTHER,Blast,and ***:A total of 104 common proteins were identified in each of the MFGM *** analysis revealed that 70.2%of identified proteins were affected by *** these,78.1%were lower in M14 compared with M1,including immune-related proteins lactotransferrin,lactadherin and *** affected 44.2%of *** the proteins affected by PAR,84.8%were higher in MP cows compared with PP cows,including apolipoprotein E and histones 2A,2B,3,and 4 *** subfamily 1 member 1A and annexin 5 were higher in samples from PP ***×parity affected 32.7%of identified proteins,including lactotransferrin,gelsolin,vitamin D binding protein,and S100 ***

关键词： colostrum Lc-MS/MS Parity

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Hypoxia Enhances the Therapeutic Potential of Superparamagnetic Iron Oxide-labeled Adipose-derived Stem cells for Myocardial Infarction

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2017年第4期37卷 516-522页

作者：王剑向波邓继先林宏宇 darren H.Freed Rakesh c.Arora 田钢虹 Department of Vascular Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China National Research council of canada Winnipeg R3B 1Y6Canada Department of Physiology Faculty of MedicineUniversity of ManitobaWinnipeg R3E 3P5Canada Department of Pharmacology and Therapeutics Faculty of MedicineUniversity of ManitobaWinnipeg R3E OT6Canada Division of cardiac Surgery University of Alberta Hospital Edmonton T6G 2B7Canada cardiac Science Program Institute of Cardiovascular ScienceSt.Boniface General Hospital Winnipeg R2H 2A6Canada

Adipose-derived stem cells（AScs） induce therapeutic angiogenesis due to pro-angiogenic cytokines secretion. Superparamagnetic iron oxide（SPIO） nanoparticles are critical for magnetic resonance（MR） tracking of implanted cells. Hypoxia is a powerful stimulus for angiogenic activity of AScs. In this study, we investigated whether therapeutic potency could be enhanced by implantation of hypoxia-preconditioned SPIO-labeled AScs（SPIOAScs） into the infarcted myocardium. AScs and SPIOAScs were cultured under 2% O_2（hypoxia） or 95% air（normoxia）. cells were intramyocardially injected into the infarcted myocardium after 48-h culture. We found that hypoxia culture increased the m RNA expression of hypoxia-inducible factor-1 alpha（HIF-1α） and vascular endothelial growth factor（VEGF） in AScs and SPIOAScs. The VEGF protein in the conditioned medium was significantly higher in hypoxic AScs and SPIOAScs than in normoxic AScs and SPIOAScs. The capillary density and left ventricular contractile function in the infarcted myocardium were significantly higher 4 weeks after implantation with hypoxic AScs and SPIOAScs than with normoxic AScs and SPIOAScs. Improvement in the capillary density and left ventricle function didn＇t differ between hypoxic AScs-transplanted rats and hypoxic SPIOAScs-transplanted rats. Hypoxic culture enhanced the angiogenic efficiency of AScs. It was concluded that implantation of hypoxic AScs or SPIOAScs promotes therapeutic angiogenesis and cardiac function recovery in the infarcted myocardium. SPIO labeling does not impact the beneficial effect of hypoxic AScs.

关键词： hypoxia adipose-derived stem cells superparamagnetic iron oxide myocardial infarction

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Effect of body mass index on functional outcome in primary total knee arthroplasty——a single institution analysis of 2180 primary total knee replacements

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World Journal of Orthopedics 2016年第10期7卷 664-669页

作者： Shane c O'Neill Joseph S Butler Adam Daly darren F Lui Patrick Kenny Department of Orthopaedics Cappagh National Orthopaedic Hospital

AIM To evaluate the effect of body mass index(BMI) on short-term functional outcome and complications in primary total knee arthroplasty. METHODS All patients undergoing primary total knee arthroplasty at a single institution between 2007 and 2013 were identified from a prospective arthroplasty database. 2180 patients were included in the study. Age, gender, BMI, pre- and post-operative functional scores [Western Ontario and Mc Master University Arthritis Index(WOMAc) and SF-36], complications and revision rate were recorded. Patients were grouped according to the WHO BMI classification. The functional outcome of the normal weight cohort(BMI compared to the overweight and obese(BMI ≥ 25) cohort. A separate sub-group analysis was performed comparing all five WHO BMI groups; Normal weight, overweight, class 1 obese, class 2 obese and class 3 *** With a mean age of 67.89(28-92), 2180 primary total knee replacements were included. 64.36%(1403) were female. The mean BMI was 31.86(18-52). Ninty-three percent of patients were either overweight or obese. Mean follow-up 19.33 mo(6-60 mo). There was no significant difference in pre or post-operative WOMAc score in the normal weight(BMI cohort compared to patients with a BMI ≥ 25(P > 0.05). Sub-group analysis revealed significantly worse WOMAc scores in class 2 obese 30.80 compared to overweight 25.80(P class 1 obese 25.50(P cantly worse SF-36 scores in class 2 obese 58.16 compared to overweight 63.93(P class 1 obese 63.65(P cial infections, 9(0.41%) deep infections and 19(0.87%) revisions overall with no complications or revisions in the normal weight cohort(BMI cONcLUSION Post-operative functional outcome was not influenced by BMI comparing normal weight individuals with BMI > 25. Patients should not be denied total knee arthroplasty based solely on weight alone.

关键词： Total knee replacement Body mass index Total knee arthroplasty

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