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Ameta-analysis on efficacy and safety:single-balloon ***-balloon enteroscopy

Gastroenterology Report 2015年第2期3卷 148-155页

作者： Vaibhav Wadhwa Saurabh Sethi Sumeet Tewani Sushil kumar Garg douglas k.pleskow Ram Chuttani Tyler M.Berzin Nidhi Sethi Mandeep S.Sawhney Department of Internal Medicine Fairview HospitalCleveland ClinicClevelandOHUSA Division of Gastroenterology Beth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMAUSA Division of Basic and Translational Research Department of SurgeryUniversity of MinnesotaMinneapolisMNUSA

Background and aim:Double-balloon enteroscopy(DBE)and single-balloon enteroscopy(SBE)are new techniques capable of providing deep *** of individual studies comparing these techniques have not been able to identify a superior *** aim was to systematically pool all available studies to compare the efficacy and safety of DBE with SBE for evaluation of the small ***:Databases were searched,including PubMed,Embase,and the Cochrane Central Register of Controlled *** main outcome measures were complete small-bowel visualization,diagnostic yield,therapeutic yield,and complication *** analysis was performed using Review Manager(RevMan version 5.2).Meta-analysis was performed using fixed-effect or random-effect methods,depending on the absence or presence of significant *** used the v2 and I2 test to assess heterogeneity between *** were expressed as risk ratios(RR)or mean differences with 95%confidence intervals(CI).Results:Four prospective,randomized,controlled trials with a total of 375 patients were *** was superior to SBE for visualization of the entire small bowel[pooled RR=0.37(95%CI:0.19–0.73;P=0.004)].DBE and SBE were similar in ability to provide diagnosis[pooled RR=0.95(95%CI:0.77–1.17;P=0.62)].There was no significant difference between DBE and SBE in therapeutic yield[pooled RR=0.78(95%CI:0.59–1.04;P=0.09)]and complication rate[pooled RR=1.08(95%CI:0.28–4.22);P=0.91].Conclusions:DBE was superior to SBE with regard to complete small bowel *** was similar to SBE with regard to diagnostic yield,ability to provide treatment and complication rate,but these results should be interpreted with caution as they is based on very few studies and the overall quality of the evidence was rated as low tomoderate,due to the small sample size.

关键词： small bowel enteroscopy single-balloon enteroscopy double-balloon enteroscopy meta-analysis outcomes

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Curators and Mediators of Language,Content,Pedagogy,and Technology:Teachers’Expanding Roles in Fully-Online CLIL Contexts

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Chinese Journal of Applied Linguistics 2025年第1期48卷 50-69,155页

作者： Yuliya Novitskaya Rebekah R.Gordon douglas k.Hartman Curtis Green-Eneix kazakh-American Free University Michigan State University The Education University of Hong kong

As world events have morphed teachers’roles within English medium of instruction(EMI)contexts to incorporate more online teaching practices,teachers’integration of digital tools has faced technological and curricular *** previous research has examined the integration of digital tools in face-to-face and hybrid EMI settings(e.g.,Finardi,2015;O’Dowd,2018),more research is needed to understand the familiarization process teachers engage in as they implement fully-online teaching to support their content and language integrated learning(CLIL)*** part of a larger project,this case study sets out to fill this gap by examining the practices and perspectives of 30 kazakhstani university teachers who adopted CLIL approaches while needing to adapt to fully-online teaching *** the concept of technological pedagogical content knowledge(Mishra&koehler,2006)in tandem with Ball et al.’s(2016)seven CLIL principles as a framework,this study thematically analyzed workshop artifacts,survey responses,semi-structured interview transcripts,and videos from online class lessons to find that teachers were mediators and curators of content,language,pedagogy,and digital *** findings offer pedagogical insights for the implementation of professional development(PD)to prepare teachers to meaningfully curate and mediate technology into their CLIL pedagogy to teach content within EMI contexts.

关键词： CLIL teacher professional development digital tools TPACk online teaching kazakhstan

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key quality indicators in colonoscopy

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Gastroenterology Report 2023年第1期11卷 49-59页

作者： douglas k.Rex Division of Gastroenterology/Hepatology Indiana University School of MedicineIndianapolisINUSA

Many quality indicators have been proposed for colonoscopy,but most colonoscopists and endoscopy groups focus on measuring the adenoma detection rate and the cecal intubation *** of proper screening and surveillance intervals is another accepted key indicator but it is seldom evaluated in clinical *** preparation efficacy and polyp resection skills are areas that are emerging as potential key or priority *** review summarizes and provides an update on key performance indicators for colonoscopy quality.

关键词： colonoscopy quality adenoma detection rate polypectomy post-polypectomy surveillance

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Multispectral light scattering endoscopic imaging of esophageal precancer

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Light(Science & Applications) 2017年第1期6卷 45-54页

作者： Le Qiu Ram Chuttani douglas k.pleskow Vladimir Turzhitsky Umar khan Yuri N Zakharov Lei Zhang Tyler M Berzin Eric U Yee Mandeep S Sawhney Yunping Li Edward Vitkin Jeffrey D Goldsmith Irving Itzkan Lev T Perelman Center for Advanced Biomedical Imaging and Photonics Division of GastroenterologyDepartment of MedicineBeth Israel Deaconess Medical CenterHarvard UniversityBostonMA 02215USA Division of Gastroenterology Department of MedicineBeth Israel Deaconess Medical CenterHarvard UniversityBostonMA 02215USA Department of Pathology Beth Israel Deaconess Medical CenterHarvard UniversityBostonMA 02215USA Department of Anesthesia Critical Care and Pain MedicineBeth Israel Deaconess Medical CenterHarvard UniversityBostonMA 02215USA Biological and Biomedical Sciences Program Harvard UniversityBostonMA 02215USA

Esophageal adenocarcinoma is the most rapidly growing cancer in *** the prognosis after diagnosis is unfavorable,the chance of a successful outcome increases tremendously if detected early while the lesion is still ***,the present standard-of-care,endoscopic surveillance,has major limitations,since dysplasia is invisible,often focal,and systematic biopsies typically sample less than one percent of the esophageal lining and therefore easily miss *** solve this problem we developed a multispectral light scattering endoscopic imaging *** surveys the entire esophageal lining and accurately detects subcellular dysplastic *** system combines light scattering spectroscopy,which detects and identifies invisible dysplastic sites by analyzing light scattered from epithelial cells,with rapid scanning of the entire esophageal lining using a collimated broadband light beam delivered by an endoscopically compatible fiber optic *** we report the results of the first comprehensive multispectral imaging study,conducted as part of routine endoscopic procedures performed on patients with suspected *** a double-blind study that characterized the system’s ability to serve as a screening tool,55 out of 57 patients were diagnosed *** addition,a smaller double-blind comparison of the multispectral data in 24 patients with subsequent pathology at locations where 411 biopsies were collected yielded an accuracy of 90%in detecting individual locations of dysplasia,demonstrating the capability of this method to serve as a guide for biopsy.

关键词： biophotonics endoscopic multispectral imaging light scattering spectroscopy noninvasive cancer detection

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Gastric cystica profunda:Another indication for minimally invasive endoscopic resection techniques?

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World Journal of Gastroenterology 2024年第27期30卷 3278-3283页

作者： Harjot k Bedi douglas Motomura Neal Shahidi Department of Medicine University of British ColumbiaVancouver V6Z 2K5BCCanada

Gastric cancer presents a significant global health burden,as it is the fifth most common malignancy and fourth leading cause of cancer mortality *** in incidence rates across regions underscores the multifactorial etiology of this *** overall 5-year survival rate remains low despite advances in its diagnosis and *** surgical gastrectomy was previously standard-of-care,endoscopic resection techniques,including endoscopic mucosal resection and endoscopic submucosal dissection(ESD)have emerged as effective alternatives for early *** to surgical resection,endoscopic resection techniques have comparable 5-year survival rates,reduced treatment-related adverse events,shorter hospital stays and lower *** also enables en bloc resection,thus affording organ-sparing curative endoscopic resection for early *** this editorial,we comment on the recent publication by Geng et al regarding gastric cystica profunda(GCP).GCP is a rare gastric pseudotumour with the potential for malignant *** presents a diagnostic challenge due to its nonspecific clinical manifestations and varied endoscopic *** are several gaps in the literature regarding the diagnosis and management of GCP which warrants further research to standardize patient *** in endoscopic resection techniques offer promising avenues for GCP and early gastric cancers.

关键词： Early gastric cancer Endoscopy Endoscopic submucosal dissection Gastric cystica profunda

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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 *** 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

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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

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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 *** 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 *** of UT3PC overcomes these impediments in three easy ***, a material properties file is prepared for the considered ***, mesh generation is automatic through an interactive process.A third and last step is simply execution of the *** 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

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Exploding lakes in Vanuatu ＂Surtseyan-style＂ eruptions witnessed on Ambae Island

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Episodes 2006年第2期29卷 87-92页

作者： károly Németh Shane J. Cronin douglas Charley Morris Harrison Esline Garae Volcanic Risk Solutions Institute of Natural Resources Massey University PO Box 11 222 Palmerston North New Zealand Department of Geology Mines and Water Resources Private Bag Port Vila Vanuatu

After a long silence, Lake Vui on Ambae Island burst into spectacular life on November 28, 2005, disrupting the lives of the 10,000 inhabitants on this sleepy tropical island in the SW Pacific. ＂Surtseyan-style＂ explosions burst through the Island＇s summit lake waters, forming a new tuff-cone, and threatening to form deadly lahars or volcanic floods. Such eruptions are rarely well observed, and these fleeting opportunities provide a chance to match volcanic processes with rock-sequences common in the geologic record...

关键词：瓦努阿图爆发湖泊岛屿

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Adjacent strong edge colorings and total colorings of regular graphs

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Science China Mathematics 2009年第5期52卷 973-980页

作者： WOODALL douglas R School of Mathematical Sciences University of NottinghamNottinghamNG7 2RDUK

It is conjectured that X as ′ (G) = X t (G) for every k-regular graph G with no C 5 component (k ? 2). This conjecture is shown to be true for many classes of graphs, including: graphs of type 1; 2-regular, 3-regular and (|V(G)| - 2)-regular graphs; bipartite graphs; balanced complete multipartite graphs; k-cubes; and joins of two matchings or cycles.

关键词： graph total coloring adjacent strong edge coloring 05C15 68R10

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