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Patient interest in video recording of colonoscopy:A survey

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World Journal of Gastroenterology 2010年第4期16卷 458-461页

作者： Meghana Raghavendra Douglas K Rex Division of Gastroenterology/Hepatology Indiana University Medical CenterIndianapolisIN 46202United States

AIM:To find if patients are interested in obtaining a video recording of their colonoscopy procedure.METHODS:We conducted a survey of outpatients presenting for colonoscopy regarding their interest in obtaining a video recording of their colonoscopy.RESULTS:Two hundred and forty-eight patients(mean age 57.9 years;57% male) were surveyed.Two hundred and one patients(81%) were interested in obtaining a video recording.No significant predictors of patients' interest in the video recording were identified.After reading a brief educational paragraph explaining missed lesions during colonoscopy,135 patients(54%) were more interested in having a video recording,and none were less interested.One hundred and fifty-six patients(63%) were willing to pay for a video recording.In multivariable analyses,younger age was predictive of willingness to pay for a video recording.Prior history of colorectal cancer and a family history of colorectal cancer were predictive of willingness to pay a greater amount.CONCLUSION:Patients undergoing colonoscopy expressed substantial interest in obtaining a videorecording of their procedure.Awareness of missing lesions during colonoscopy increased interest in having a videorecording.

关键词： Colonoscopy Video recording Survey

Reinterpretation of histology of proximal colon polyps called hyperplastic in 2001

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World Journal of Gastroenterology 2009年第30期15卷 3767-3770页

作者： Omer khalid Sofyan Radaideh Oscar W Cummings Michael J O'Brien John R Goldblum Douglas K Rex Department of Medicine Indiana University Medical CenterIndianapolisIN 46202United States Department of Pathology Indiana University Medical CenterIndianapolisIN 46202United States Department of Anatomic Pathology Boston University Medical CenterBostonMA 02118United States Department of Anatomic Pathology Cleveland ClinicClevelandOH 44195United States Division of Gastroenterology/Hepatology Indiana University Medical CenterIndianapolisIN 46202United States

AIM: To evaluate how proximal colon polyps interpreted as hyperplastic polyps in 2001 would be interpreted by expert pathologists in 2007. METHODS: Forty consecutive proximal colon polyps ≥ 5 mm in size, removed in 2001, and originally interpreted as hyperplastic polyps by general pathologists at Indiana University, were reviewed in 2007 by 3 GI pathologists. RESULTS: The gastrointestinal (GI) pathologists interpreted 85%, 43% and 30% of the polyps as sessile serrated polyps (sessile serrated adenomas). The overall kappa was 0.16. When diagnoses were compared in pairs, kappa values were 0.38 and 0.25 (fair agreement) and 0.14 (slight agreement). CONCLUSION: Many polyps interpreted as hyperplastic in 2001 were considered sessile serrated lesions by GI pathologists in 2007, but there is substantial inter-observer variation amongst GI pathologists.

关键词：增生性结肠组织学肉解读病理学印第安纳胃肠

Multicenter,randomized study to optimize bowel for colon capsule endoscopy

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World Journal of Gastroenterology 2017年第48期23卷 8615-8625页

作者： David kastenberg Wilmot C Burch Jr David P Romeo Pankaj k kashyap David C Pound Neophytos Papageorgiou Ignacio Fernández-Urien Sainz Carly E Sokach Douglas K Rex Division of Gastroenterology Thomas Jefferson University Franklin Gastroenterology PLLC Dayton Gastroenterology Inc. Pinnacle Research Group LLC Indianapolis Gastroenterology and hepatology Department of Gastroenterology American Medical Center Department of Gastroenterology Servicio de Digestivohospital de Navarra Sidney kimmel Medical College at Thomas Jefferson University Indiana University hospital

AIM To assess the cleansing efficacy and safety of a new Colon capsule endoscopy(CCE) bowel preparation regimen.METHODS This was a multicenter,prospective,randomized,controlled study comparing two CCE regimens. Subjects were asymptomatic and average risk for colorectal cancer. The second generation CCE system(Pill Cam? COLON 2;Medtronic,Yoqneam,Israel) was utilized. Preparation regimens differed in the 1 st and 2 nd boosts with the Study regimen using oral sulfate solution(89 m L) with diatrizoate meglumine and diatrizoate sodium solution("diatrizoate solution")(boost 1 = 60 m L,boost 2 = 30 m L) and the Control regimen oral sulfate solution(89 m L) alone. The primary outcome was overall and segmental colon cleansing. Secondary outcomes included safety,polyp detection,colonic transit,CCE completion and capsule excretion ≤ 12 h. RESULTS Both regimens had similar cleansing efficacy for the whole colon(Adequate: Study = 75.9%,Control = 77.3%;P = 0.88) and individual segments. In the Study group,CCE completion was superior(Study = 90.9%,Control = 76.9%;P = 0.048) and colonic transit was more often < 40 min(Study = 21.8%,Control = 4%;P = 0.0073). More Study regimen subjects experienced adverse events(Study = 19.4%,Control = 3.4%;P = 0.0061),and this difference did not appear related to diatrizoate solution. Adverse events were primarily gastrointestinal in nature and no serious adverse events related either to the bowel preparation regimen or the capsule were observed. There was a trend toward higher polyp detection with the Study regimen,but this did not achieve statistical significance for any size category. Mean transit time through the entire gastrointestinal tract,from ingestion to excretion,was shorter with the Study regimen while mean colonic transit times were similar for both study groups.CONCLUSION A CCE bowel preparation regimen using oral sulfate solution and diatrizoate solution as a boost agent is effective,safe,and achieved superior CCE completion.

关键词： Bowel preparation Purgative Capsule endoscopy Endoscopy Capsule colonoscopy Large intestine

Outcomes of submucosal(T1b) esophageal adenocarcinomas removed by endoscopic mucosal resection

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World Journal of Gastrointestinal Endoscopy 2016年第20期8卷 763-769页

作者： Darren D Ballard Neel Choksi Jingmei Lin Eun-Young Choi B Joseph Elmunzer Henry Appelman Douglas K Rex Hala Fatima William kessler John M DeWitt Division of Gastroenterology and Hepatology Medical College of Wisconsin Division of Gastroenterology University of Michigan Department of Pathology Indiana University Department of Pathology University of Michigan Division of Gastroenterology and Hepatology University of South Carolina Division of Gastroenterology and Hepatology Indiana University

AIM To investigate the outcomes and recurrences of p T1 b esophageal adenocarcinoma(EAC) following endoscopic mucosal resection(EMR) and associated treatments.METHODS Patients undergoing EMR with pathologically confirmed T1 b EAC at two academic referral centers were retrospectively identified.Patients were divided into 4 groups based on treatment following EMR:Endoscopic therapy alone(group A),endoscopic therapy with either chemotherapy,radiation or both(group B),surgicalresection(group C) or no further treatment/lost to follow-up(<12 mo)(group D).Pathology specimens were reviewed by a central pathologist.Follow-up data was obtained from the academic centers,primary care physicians and/or referring physicians.Univariate analysis was performed to identify factors predicting recurrence of EAC.RESULTS Fifty-three patients with T1 b EAC underwent EMR,of which 32(60%) had adequate follow-up ≥ 12 mo(median 34 mo,range 12-103).There were 16 patients in group A,9 in group B,7 in group C and 21 in group D.Median follow-up in groups A to C was 34 mo(range 12-103).Recurrent EAC developed overall in 9 patients(28%) including 6(38%) in group A(median:21 mo,range:6-73),1(11%) in group B(median:30 mo,range:30-30) and 2(29%) in group C(median 21 mo,range:7-35.Six of 9 recurrences were local;of the 6 recurrences,5 were treated with endoscopy alone.No predictors of recurrence of EAC were identified.CONCLUSION Endoscopic therapy of T1 b EAC may be a reasonable strategy for a subset of patients including those either refusing or medically unfit for esophagectomy.

关键词： Esophageal cancer Submucosal T1b Endoscopic mucosal resection Chemotherapy Esophagectomy

Propagation of tau and α-synuclein in the brain: therapeutic potential of the glymphatic system

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Translational Neurodegeneration 2022年第1期11卷 667-689页

作者： douglas M.Lopes Sophie k.Llewellyn Ian F.Harrison Division of Medicine Department of ImagingCentre for Advanced Biomedical ImagingFaculty of Medical SciencesUniversity College LondonPaul O’Gorman Building72 Huntley StreetLondon WC1E 6DDUK

Many neurodegenerative diseases, including Alzheimer’s disease and Parkinson’s disease, are characterised by the accumulation of misfolded protein deposits in the brain, leading to a progressive destabilisation of the neuronal network and neuronal death. Among the proteins that can abnormally accumulate are tau and α-synuclein, which can propagate in a prion-like manner and which upon aggregation, represent the most common intracellular proteinaceous lesions associated with neurodegeneration. For years it was thought that these intracellular proteins and their accumulation had no immediate relationship with extracellular homeostasis pathways such as the glymphatic clearance system;however, mounting evidence has now suggested that this is not the case. The involvement of the glymphatic system in neurodegenerative disease is yet to be fully defined;however, it is becoming increasingly clear that this pathway contributes to parenchymal solute clearance. Importantly, recent data show that proteins prone to intracellular accumulation are subject to glymphatic clearance, suggesting that this system plays a key role in many neurological disorders. In this review, we provide a background on the biology of tau and α-synuclein and discuss the latest findings on the cell-to-cell propagation mechanisms of these proteins. Importantly, we discuss recent data demonstrating that manipulation of the glymphatic system may have the potential to alleviate and reduce pathogenic accumulation of propagation-prone intracellular cytotoxic proteins. Furthermore, we will allude to the latest potential therapeutic opportunities targeting the glymphatic system that might have an impact as disease modifiers in neurodegenerative diseases.

关键词： Glymphatic Propagation Tauopathy Synucleinopathy Clearance Aquaporin-4

Effects of overburden characteristics on dynamic failure in underground coal mining

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International Journal of Mining Science and Technology 2017年第1期27卷 121-129页

作者： Lawson Heather E. Tesarik douglas Larson Mark k Abraham Habte NIOSH Office of Mine Safety and Health ResearchGround Control BranchSpokane WA 99207USA

Dynamic failures, or ‘‘bumps", remain an imperative safety concern in underground coal mining, despite significant advancements in engineering controls. The presence of spatially discrete, stiff roof units are one feature that has been linked to these events. However, an empirical stratigraphic review indicates that no significant difference exists in the relative commonality of discrete units between bumping and non-bumping deposits. Instead an apparent relationship exists between reportable bumping and the overall stiffness of the host rock. However, this initial study is too simplistic to be conclusive; to weight the relative impact of changes in a single variable, such as the thickness or location of sandstone members, it must be examined in isolation—i.e., in a setting where all other variables are held constant.Numerical modelling provides this setting, and the effects of variability in a stiff discrete member in a hypothetical longwall mining scenario are investigated within the context of three stratigraphic ‘‘types",Compliant, Intermediate and Stiff. A modelling experiment examines changes in rupture potential in stiff roof units for each stratigraphic type as discrete unit thickness and location are manipulated through a range of values. Results suggest that the stiff-to-compliant ratio of the host rock has an impact on the relative stress-inducing effects of discrete stiff members. In other words, it is necessary to consider both the thickness and the distance to the seam, within the context of the host rock, to accurately anticipate areas of elevated rupture-induced hazard; acknowledging the presence of a discrete unit within the overburden in general terms is an insufficient indicator of risk. This finding helps to refine our understanding of the role of individual stiff, strong roof members in bumping phenomena, and suggests that a holistic view of overburden lithology and site-specific numerical modelling may be necessary to improve miner safety.

关键词： Dynamic failure Coal mining Bumps Bounces

Transition to forefoot strike reduces load rates more effectively than altered cadence

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Journal of Sport and Health Science 2020年第3期9卷 248-257页

作者： Erin E.Futrell k.douglas Gross Darcy Reisman David R.Mullineaux Irene S.Davis Department of Physical Therapy Springfield CollegeSpringfieldMA 01109USA Spaulding National Running Center Harvard Medical SchoolCambridgeMA 02138USA Department of Physical Therapy MGH Institute of Health ProfessionsBostonMA 02129USA Department of Physical Therapy University of DelawareNewarkDE 19713USA School of Sport and Exercise Science University of LincolnBrayford PoolLincolnBrayford PoolLN67TSUK Department of Physical Medicine and Rehabilitation Harvard Medical SchoolBostonMA 02115USA

Background: Excessive vertical impacts at landing are associated with common running injuries. Two primary gait-retraining interventions aimed at reducing impact forces are transition to forefoot strike and increasing cadence. The objective of this study was to compare the shortand long-term effects of 2 gait-retraining interventions aimed at reducing landing impacts.Methods: A total of 39 healthy recreational runners using a rearfoot strike and a cadence of 170 steps/min were randomized into cadence(CAD) or forefoot strike(FFS) groups. All participants performed 4 weeks of strengthening followed by 8 sessions of gait-retraining using auditory feedback. Vertical average load rates(VALR) and vertical instantaneous load rates(VILR) were calculated from the vertical ground reaction force curve. Both cadence and foot strike angle were measured using 3D motion analysis and an instrumented treadmill at baseline and at 1 week,1 month, and 6 months post retraining.Results: ANOVA revealed that the FFS group had significant reductions in VALR(49.7%) and VILR(41.7%), and changes were maintained long term. Foot strike angle in the FFS group changed from 14.2° dorsiflexion at baseline to 3.4° plantarflexion, with changes maintained long term. The CAD group exhibited significant reduction only in VALR(16%) and only at 6 months. Both groups had significant and similar increases in cadence at all follow-ups(CAD, +7.2% to 173 steps/min;and FFS, +6.1% to 172 steps/min).Conclusion: Forefoot strike gait-retraining resulted in significantly greater reductions in VALR and similar increases in cadence compared to cadence gait-retraining in the short and long term. Cadence gait-retraining resulted in small reductions in VALR at only the 6-month follow-up.

关键词： Foot strike Gait-retraining Physical therapy Running Step rate

User-friendly finite element design of main entries, barrier pillars,and bleeder entries

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International Journal of Mining Science and Technology 2018年第1期28卷 3-10页

作者： William G.Pariseau Mark k.Larson Heather E.Lawson douglas R.Tesarik Department of Mining Engineering University of Utah Spokane Mining Research Division NIOSH

This contribution describes development and application of a user-friendly finite element program,UT3PC, to address three important problems in underground coal mine design:(1) safety of main entries,(2) barrier pillar size needed for entry protection, and(3) safety of bleeder entries during the advance of an adjacent longwall panel.While the finite element method is by far the most popular engineering design tool of the digital age, widespread use by the mining community has been impeded by the relatively high cost of and the need for lengthy specialized training in numerical methods.Implementation of UT3PC overcomes these impediments in three easy steps.First, a material properties file is prepared for the considered site.Next, mesh generation is automatic through an interactive process.A third and last step is simply execution of the program.Examples using data from several western coal mines illustrate the ease of using the application for analysis of main entries, barrier pillars, and bleeder entry safety.

关键词： Finite element Coal Mine layout design Main entries Barrier pillars Bleeder entries

基于SAVEE方法的海岛空间价值评价——以南沙群岛为例

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海洋环境科学 2012年第1期31卷 107-110页

作者：陈韶阳程镇燕 douglas k Loh 中国海洋大学海洋环境学院天津农学院水产科学系水产生态及水产养殖重点实验室 Department of Ecosystems Science and Management Texas A&M UniversityCollege StationTX 77840USA

对SAVEE评价方法的理论基础、分析步骤、应用条件和优缺点进行了系统归纳和总结,构建了SAVEE评价分析模型。以南沙群岛的空间价值评价为例开展实证研究,尝试将SAVEE方法应用于海岛空间价值评价。结果表明:SAVEE评价法计算简便,可操作性... 详细信息

对SAVEE评价方法的理论基础、分析步骤、应用条件和优缺点进行了系统归纳和总结,构建了SAVEE评价分析模型。以南沙群岛的空间价值评价为例开展实证研究,尝试将SAVEE方法应用于海岛空间价值评价。结果表明:SAVEE评价法计算简便,可操作性强,能够量化体现每个因子价值,评价结果清晰易懂。SAVEE为空间价值评价方法提供了新的选择,具有极大的应用前景。

关键词：海岛空间价值评价 SAVEE 影响因子南沙群岛不确定性推理