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Endoscopic ultrasound-guided portal pressure gradient identifies patients with previously undiagnosed clinically significant portal hypertension

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Portal Hypertension & Cirrhosis 2024年第2期3卷 67-74页

作者： Jerome C.Edelson Scott F.D.Edelson John G.Quiles Cyrus V.Edelson Eric M.Montminy Christian L.Horn John P.Magulick don C.Rockey Department of Gastroenterology and Hepatology Brooke Army Medical CenterFort Sam HoustonTexasUSA Department of Medicine Uniformed Services University of the Health SciencesBethesdaMarylandUSA Department of Medicine Brooke Army Medical CenterFort Sam HoustonTexasUSA John H.Stroger jr.Hospital of Cook County ChicagoIllinoisUSA Digestive Disease Research Center Medical University of South CarolinaCharlestonSouth CarolinaUSA

Aims:Portal hypertension(PH)is a complication of cirrhosis that leads to hepatic *** the portal pressure gradient(PPG)provides valuable information for disease assessment,staging,and *** this study,we aimed to report the utilization of endoscopic ultrasound(EUS)-guided PPG(EUS-PPG)measurements in a real-world ***:This retrospective analysis included patients at a tertiary care center who underwent EUS-PPG between February 2021 and May *** most common indication was to establish or exclude the diagnosis of cirrhosis,followed by an assessment of surgical risk in the setting of suspected *** demographic and clinical data were collected,and statistical analysis was performed using the Student's t ***:Eighteen patients underwent *** success was achieved in 17 of the 18 *** complications were *** mean scores of Child-Pugh,Model for End-Stage Liver Disease-Sodium,and Fibrosis-4 scores were 5.1±0.5,9.0±3.0,and 3.7±4.5,*** the 18 patients,two presented with esophageal varices and six with portal hypertensive *** mean PPG was 5.8±4.5 mmHg,and five patients exhibited clinically significant PH(CSPH).Of the 18 patients,15 underwent concurrent EUS-liver biopsy,which was 100%successful and provided diagnostic histology for all *** PPG data led to changes in the clinical management of 17 ***:EUS-PPG is safe and technically *** Child-Pugh score did not correlate well with the presence of CSPH;however,PPG measurements resulted in changes in the management of almost all *** studies correlating EUS-PPG with other assessments of liver diseases are required.

关键词： EUS portal hypertension portal pressure gradient

Role of CFTR mutation analysis in the diagnostic algorithm for cystic fibrosis

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World Journal of Pediatrics 2017年第2期13卷 129-135页

作者： Michelle Ratkiewicz Matthew Pastore Karen Sharrock McCoy Rohan Thompson don Hayes jr. Shahid Ijaz Sheikh Departments of Pediatrics the Ohio State University College of Medicine ColumbusOhioUSA Section of Pulmonary Medicine Nationwide Children's HospitalColumbusOhioUSA Departments of Pediatrics the Ohio State University College of Medicine ColumbusOhioUSA Section of Human and Molecular Genetics Nationwide Children's HospitalColumbusOhioUSA Departments of Pediatrics the Ohio State University College of Medicine ColumbusOhioUSA Internal Medicine the Ohio State University College of Medicine ColumbusOhioUSA Section of Pulmonary Medicine Nationwide Children's HospitalColumbusOhioUSA

Background:The cystic fibrosis transmembrane conductance regulator (CFTR) gene mutation identification is being used with increased frequency to aid in the diagnosis of cystic fibrosis (CF) in those suspected with *** of this study was to identify diagnostic outcomes when CFTR mutational analysis was used in CF *** mutational analysis results were also compared with sweat chloride ***:This study was done on all patients at our institution who had CFTR mutation analysis over a sevenyear period since August ***:A total of 315 patients underwent CFTR mutational ***-one (16.2%) patients had two mutations *** them 32 had positive sweat chloride levels (≥60 mmol/L),while seven had borderline sweat chloride levels (40-59 mmol/L).An additional 70 patients (22.3%) had only one mutation *** them eight had positive sweat chloride levels,and 17 had borderline sweat chloride ***-five patients (17.5%) without CFTR mutations had either borderline (n=45) or positive (n=10) sweat chloride *** patients with a CF phenotype had negative CFTR analysis but elevated sweat chloride *** eighty-three patients (26.4%) CFTR mutational analysis was done without corresponding sweat chloride ***:Although CFTR mutation analysis has improved the diagnostic capability for CF,its use either as the first step or the only test to diagnose CFTR dysfunction should be discouraged and CF diagnostic guidelines need to be followed.

关键词： CFTR cystic fibrosis sweat chloride

Organizational Behavior don Hellriegel, John W. Slocum, jr.

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Improved speciation of dissolved organic nitrogen in natural waters: amide hydrolysis with fluorescence derivatization

2007年

作者： don Hellriegel John W. Slocum jr.

来源：畅想之星图书光盘版（南... 评论

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Journal of Environmental Sciences 2008年第10期20卷 1273-1280页

作者： Ryan L.Fimmen Tamara D.Trouts Daniel D.Richter jr. Dharni Vasudevan School of Earth Sciences The Ohio State University 125 S.Oval MallColumbus OH 43210 USA.Nicholas School of the Environment and Earth Sciences Duke University Durham NC 27708 USA School of Earth Sciences The Ohio State University 125 S.Oval MallColumbus OH 43210 USA Nicholas School of the Environment and Earth Sciences Duke UniversityDurham NC 27708 USA. Nicholas School of the Environment and Earth Sciences Duke UniversityDurham NC 27708 USA.Department of Chemistry Bowdoin CollegeBrunswick ME 04011 USA

The objective of this study was to improve primary-amine nitrogen (1°-N) quantification in dissolved organic matter (DOM) originating from natural waters where inorganic forms of N, which may cause analytical interference, are commonly encountered. Efforts were targeted at elucidating organic-N structural criteria influencing the response of organic amines to known colorimetric and fluorescent reagents and exploring the use of divalent metal-assisted amide hydrolysis in combination with fluorescence analyse...

关键词： dissolved organic matter/nitrogen (DOM/don) o-phthaldialdehyde fluorescamine ninhydrin amino acids amide hydrolysis peptides

Crowdsourcing to identify social innovation initiatives in health in low- and middleincome countries

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Infectious Diseases of Poverty 2020年第5期9卷 123-123页

作者： Lindi van Niekerk Arturo Ongkeko jr. Rachel Alice Hounsell Barwani Khaura Msiska don Pascal Mathanga Josselyn Mothe Noel Juban Phyllis Awor Dina Balabanova 不详 College of Medicine University of MalawiBlantyreMalawi

Background:Crowdsourcing is a distributed problem-solving and production mechanism that leverages the collective intelligence of non-expert individuals and networked communities for specific *** innovation(SI)initiatives aim to address health challenges in a sustainable manner,with a potential to strengthen health *** are developed by actors from different backgrounds and *** paper describes the application of crowdsourcing as a research method to explore SI initiatives in ***:The study explored crowdsourcing as a method to identify SI initiatives implemented in Africa,Asia and Latin *** crowdsourcing has been used in high-income country settings,there is limited knowledge on its use,benefits and challenges in low-and middle-income country(LMIC)*** 2014 to 2018,six crowdsourcing contests were conducted at global,regional and national ***:A total of 305 eligible projects were identified;of these 38 SI initiatives in health were *** describe the process used to perform a crowdsourcing contest for SI,the outcome of the contests,and the challenges and opportunities when using this mechanism in ***:We demonstrate that crowdsourcing is a participatory method,that is able to identify bottom-up or grassroots SI initiatives developed by non-traditional actors.

关键词： Social innovation Health Crowdsourcing Grassroots initiatives Participatory research

领导者当务之急:谋划后新冠疫情时期的在线学习

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中国远程教育 2020年第7期 1-6,40,76页

作者： [加/美]唐·奥尔科特肖俊洪(译) 美国马里兰大学环球校区德国奥尔登堡大学汕头广播电视大学

远程教育机构能否转型为蓬勃发展的创新型教育实体关键取决于其领导者是否具有远见卓识。不管是中国国家开放大学和美国马里兰大学环球校区,还是南非大学和英国开放大学,尽管这些主流远程教育机构采用不同技术,但是它们都有一个共同点:... 详细信息

远程教育机构能否转型为蓬勃发展的创新型教育实体关键取决于其领导者是否具有远见卓识。不管是中国国家开放大学和美国马里兰大学环球校区,还是南非大学和英国开放大学,尽管这些主流远程教育机构采用不同技术,但是它们都有一个共同点:其领导者具有远见卓识。本文针对因新冠疫情而大规模开展的在线学习和后新冠时期在线学习的发展,提出三个关键规划和决策阶段:第一阶段,重点是继续保持快速应急的态势;第二阶段,领导者必须决定新冠肺炎全球危机是否促使其机构今后全面推广在线学习,转型为真正意义上的在线教育机构;第三阶段,着眼于长远目标,使其具有独特价值观、文化和使命的新机构模式得以制度化。领导者应该动员其管理团队和全体员工从现在开始谋划好这三个阶段的工作。

关键词：领导才能在线学习教育机构转型教育机构规划教育机构文化数字技术制定愿景新冠疫情

在液晶显示器和EL显示器中推行DC/AC变换器

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今日电子 2001年第8期 29-30页

作者： don jensen 刘邦彦 Endicott Research Group公司

了解如何选择和确定DC/AC变换器,能够有助于实现应用的要求,而且还能满足较小的板面空间、较高的性能和更长的电池寿命的需要。

关键词：液晶显示器场致发光显示器 DC/AC变换器

Comparison of Three Macroinvertebrate Sampling Methods for Use in Assessment of Water Quality Changes in Flashy Urban Streams

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Journal of Environmental Protection 2020年第8期11卷 585-609页

作者： Roger Yeardley jr. Scott Jacobs Ken Fritz William Thoeny Office of Research and Development U.S. Environmental Protection Agency Cincinnati USA Pegasus Technical Services c/o U.S. Environmental Protection Agency Cincinnati USA

The unique challenges associated with sampling of macroinvertebrates in flashy urban streams create a methods gap. These streams form isolated pools for much of the year, interspersed with spates that scour and deposit excessive amounts of sediment. Commonly used stream grab sampling methods, such as nets and Hess and Surber fixed-area samplers, work well in wadable streams with perennial flow. Deployed samplers (Hester-Dendy, gravel tray) can be used in waters with or without flow. We evaluated three methods which don’t require stream flow: modified Hester-Dendy (MHD), gravel tray, and bucket (a type of cylinder grab sample method), for their potential use in bioassessment of a project involving daylighting of a 180-m culvert on Congress Run, a flashy urban tributary to Mill Creek in Cincinnati, Ohio. Method efficacy was measured using three criteria: usability (level of effort and recoverability of samplers), variability, and community retrieval completeness. The bucket method required the lowest level of effort and had the highest sample recovery. The bucket sampler had the lowest variability for most metrics, including the critical metric of taxa richness, with a coefficient of variation (CV) of 20.9%. The MHD and tray samplers had taxa richness CVs of 42.9% and 53.9%, respectively. The bucket sampler also had the lowest CV (27.4%) for a multi-metric index. The bucket sampler performed best with respect to community retrieval completeness, with higher pooled and average taxa richness. The total number of taxa collected from all the replicate bucket grab samples (42) was greater than that collected by the HD and tray samplers combined (27). Multivariate analyses showed significant grouping with respect to methods and location. This study supports the bucket grab sampler method as a candidate for sampling of flashy urban streams.

关键词： Macroinvertebrate Methods Stream Urban Sampling Flow Hydrology

Impact of transjugular intrahepatic porto-systemic shunt on post liver transplantation outcomes: Study based on the United Network for Organ Sharing database

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World Journal of Hepatology 2017年第2期9卷 99-105页

作者： Khalid Mumtaz Sherif Metwally Rohan M Modi Nishi Patel Dmitry Tumin Anthony J Michaels James Hanje Ashraf El-Hinnawi don Hayes jr.Sylvester M Black Wexner Medical Center Gastroenterology Hepatology and Nutrition Division the Ohio State University Department of Internal Medicine the Ohio State University Department of Pediatrics the Ohio State University Department of Surgery the Ohio State University Section of Pulmonary Medicine the Ohio State University

AIM To determine the impact of transjugular intrahepatic porto-systemic shunt(TIPS) on post liver transplantation(LT) *** Utilizing the United Network for Organ Sharing(UNOS) database, we compared patients who underwent LT from 2002 to 2013 who had underwent TIPS to those without TIPS for the management of ascites while on the LT waitlist. The impact of TIPS on 30-d mortality, length of stay(LOS), and need for re-LT were studied. For evaluation of mean differences between baseline characteristics for patients with and without TIPS, we used unpaired t-tests for continuous measures and χ~2 tests for categorical measures. We estimated the impact of TIPS on each of the outcome measures. Multivariate analyses were conducted on the study population to explore the effect of TIPS on 30-d mortality post-LT, need for re-LT and LOS. All covariates were included in logistic regression *** We included adult patients(age ≥ 18 years) who underwent LT from May 2002 to September 2013. Only those undergoing TIPS after listing and before liver transplant were included in the TIPS group. We excluded patients with variceal bleeding within two weeks of listing for LT and those listed for acute liver failure or hepatocellular carcinoma. Of 114770 LT in the UNOS database, 32783(28.5%) met inclusion criteria. Of these 1366(4.2%) had TIPS between the time of listing and LT. We found that TIPS increased the days on waitlist(408 ± 553 d) as compared to those without TIPS(183 ± 330 d), P < 0.001. Multivariate analysis showed that TIPS had no effect on 30-d post LT mortality(OR = 1.26; 95%CI: 0.91-1.76) and re-LT(OR = 0.61; 95%CI: 0.36-1.05). Pre-transplant hepatic encephalopathy added 3.46 d(95%CI: 2.37-4.55, P < 0.001), followed by 2.16 d(95%CI: 0.92-3.38, P = 0.001) by TIPS to LOS. CONCLUSION TIPS did increase time on waitlist for LT. More importantly, TIPS was not associated with 30-d mortality and re-LT, but it did lengthen hospital LOS after transplantation.

关键词： Transjugular intrahepatic porto 全身的分流分流肝移植腹水为结束阶段肝疾病当模特儿死亡 Transjugular