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Routine colonic endoscopic evaluation following resolution of acute diverticulitis:Is it necessary?

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World Journal of Gastroenterology 2014年第35期20卷 12509-12516页

作者： Amit k Agarwal Burzeen E karanjawala Justin A Maykel eric k johnson Scott R Steele Department of Surgery University of Texas Health Science Center-Houston Department of Surgery University of Texas Health Science Center-Houston and Lyndon B.Johnson General Hospital University of Massachusetts Memorial Medical Center Colon Rectal Surgery Department of SurgeryMadigan Army Medical Center

Diverticular disease incidence is increasing up to 65% by age 85 in industrialized nations,low fiber diets,and in younger and obese ***-five percent of patients with diverticulosis will develop acute *** imposes a significant burden on healthcare systems,resulting in greater than 300000 admissions per year with an estimated annual cost of $3 billion *** computed tomography(CT) is the diagnostic study of choice,with a sensitivity and specificity greater than 95%.Unfortunately,similar CT findings can be present in colonic neoplasia,especially when perforated or *** prompted professional societies such as the American Society of Colon Rectal Surgeons to recommend patients undergo routine colonoscopy after an episode of acute diverticulitis to rule out ***,the data supporting routine colonoscopy after acute diverticulitis is sparse and based small cohort studies utilizing outdated *** any patient with an indication for a colonoscopy should undergo appropriate endoscopic evaluation,in the era of widespread use of high-resolution computed tomography,routine colonic endoscopic evaluation following resolution of acute uncomplicated diverticulitis poses additional costs,comes with inherent risks,and may require further *** this manuscript,we review the current data related to this recommendation.

关键词： Colonic evaluation Colonoscopy Diverticulitis Acute diverticulitis Colonic neoplasia Endoscopy

Endoscopy and polyps-diagnostic and therapeutic advances in management

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World Journal of Gastroenterology 2013年第27期19卷 4277-4288页

作者： Scott R Steele eric k johnson Bradley Champagne Brad Davis Sang Lee David Rivadeneira Howard Ross Dana A Hayden Justin A Maykel Department of Surgery Madigan Army Medical CenterMadigan Health SystemTacoma Division of Colon and Rectal Surgery Case Western Reserve Medical Center Department of Surgery University of Cincinnati Division of Colon and Rectal Surgery Weill Cornell Medical College Department of Surgery Huntington Hospital/North Shore-LIJ Health System Department of Surgery Riverview Plaza Riverview Medical CenterRed Bank Department of Surgery Loyola University Health System Division of Colon and Rectal Surgery University of Massachusetts Memorial Medical Center

Despite multiple efforts aimed at early detection through screening, colon cancer remains the third leading cause of cancer-related deaths in the United States, with an estimated 51000 deaths during 2013 alone. The goal remains to identify and remove benign neoplastic polyps prior to becoming invasive cancers. Polypoid lesions of the colon vary widely from hyperplastic, hamartomatous and inflammatory to neoplastic adenomatous growths. Although these lesions are all benign, they are common, with up to one-quarter of patients over 60 years old will develop pre-malignant adenomatous polyps. Colonoscopy is the most effective screening tool to detect polyps and colon cancer, although several studies have demonstrated missed polyp rates from 6%-29%, largely due to variations in polyp size. This number can be as high as 40%, even with advanced (> 1 cm) adenomas. Other factors including sub-optimal bowel preparation, experience of the endoscopist, and patient anatomical variations all affect the detection rate. Additional challenges in decision-making exist when dealing with more advanced, and typically larger, polyps that have traditionally required formal resection. In this brief review, we will explore the recent advances in polyp detection and therapeutic options.

关键词： Polyps Endoscopy Colonoscopy Endoscopic submucosal dissection Endoscopic mucosal resection Quality Combined endoscopic-laparoscopic resection Combined laparoscopic-endoscopic resection Combined endoscopic-laparoscopic surgery

Operative considerations for rectovaginal fistulas

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World Journal of Gastrointestinal Surgery 2015年第8期7卷 133-137页

作者： kevin R kniery eric k johnson Scott R Steele Department of Surgery Division of Colorectal SurgeryMadigan Army Medical Center

To describe the etiology, anatomy and pathophysiology of rectovaginal fistulas(RVFs); and to describe a systematic surgical approach to help achieve optimal outcomes. A current review of the literature was performed to identify the most up-to-date techniques and outcomes for repair of RVFs. RVFs present a difficult problem that is frustrating for patients and surgeons alike. Multiple trips to the operating room are generally needed to resolve the fistula, and the recurrence rate approaches40% when considering all of the surgical options. At present, surgical options range from collagen plugs and endorectal advancement flaps to sphincter repairs or resection with colo-anal reconstruction. There are general principles that will allow the best chance for resolution of the fistula with the least morbidity to the patient. These principles include: resolving the sepsis, identifying the anatomy, starting with least invasive surgical options, and interposing healthy tissue for complex or recurrent fistulas.

关键词： Rectovaginal fistulas Anovaginal fistulas

An NSQIP evaluation of practice patterns and outcomes following surgery for anorectal abscess and fistula in patients with and without Crohn’s disease

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Gastroenterology Report 2013年第1期1卷 58-63页

作者： Marlin Wayne Causey Daniel Nelson eric k.johnson Justin Maykel Brad Davis David E.Rivadeneira Brad Champagne Scott R.Steele Department of Surgery Madigan Army Medical SystemMadigan Health SystemTacomaWA 98431USA

Background:Patients with Crohn’s disease(CD)are believed to have more aggressive anorectal abscess and fistula *** assessed the types of procedures performed and perioperative complications associated with the surgical management of anorectal abscess and fistula disease in patients with and without ***:The American College of Surgeons National Surgical Quality Improvement Program database(ACS-NSQIP,2005-2010)was used to calculate 30-day outcomes using regression modeling,accounting for demographics,comorbidities and surgical ***-9 codes for anorectal abscess or fistula were used for initial *** were then stratified,based on the presence or absence of underlying *** procedures included incision and drainage of abscesses,fistulotomy and seton *** fistulas were considered simple,while all others were classified as complex(-vaginal,-urethral and-vesical).Results:A total of 7,218 patients(mean age 45 years;64%male)met inclusion criteria,with underlying CD in 345(4.8%).CD patients were more likely to have a seton placed(9.9 vs 8.2%,Pk of functional independence(OR=2.0),pre-operative weight loss(OR=2.6)and pre-operative acute renal failure(OR=5.6).Steroids were al

关键词： National Surgical Quality Improvement Program(NSQIP) Crohn’s disease anorectal diseases anorectal abscess fistula-in-ano

A classical equation that accounts for observations of non-Arrhenius and cryogenic grain boundary migration

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npj Computational Materials 2022年第1期8卷 1492-1500页

作者： eric R.Homer Oliver k.johnson Darcey Britton James E.Patterson eric T.Sevy Gregory B.Thompson Department of Mechanical Engineering Brigham Young UniversityProvoUT84602USA Department of Chemistry and Biochemistry Brigham Young UniversityProvoUT84602USA Department of Metallurgical and Materials Engineering University of AlabamaTuscaloosaAL35401USA

Observations of microstructural coarsening at cryogenic temperatures,as well as numerous simulations of grain boundary motion that show faster migration at low temperature than at high temperature,have been troubling because they do not follow the expected Arrhenius *** work demonstrates that classical equations,that are not simplified,account for all these oddities and demonstrate that non-Arrhenius behavior can emerge from thermally activated *** to this classical model,this occurs when the intrinsic barrier energies of the processes become small,allowing activation at cryogenic *** thermal energy then allows the low energy process to proceed in reverse,so increasing temperature only serves to frustrate the forward *** classical form is shown to reconcile and describe a variety of diverse grain boundary migration observations.

关键词： cryogenic grain boundary

美国结直肠外科医师协会2019版藏毛窦诊治临床实践指南

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结直肠肛门外科 2019年第4期25卷 363-374页

作者： eric k.johnson,M.D. Jon D.Vogel,M.D. Michelle L.Cowan,M.D. Daniel L.Feingold,M.D. Scott R.Steele,M.D.,M.B.A. 杜涛张振宇冷株赟傅传刚 Uniformed Services University of the Health Sciences Cleveland Clinic Foundation Department of Surgery University of Colorado Department of Surgery New York Presbyterian Hospital Columbia University Department of Colon and Rectal Surgery Cleveland Clinic Foundation 同济大学附属东方医院胃肠肛肠外科

美国结直肠外科医师协会(The American Society of Colon and Rectal Surgeons,ASCRS)于2019年2月公布了最新的藏毛窦诊治临床实践指南。指南是由国际知名结直肠外科专家组成的临床实践指南委员会修订,对藏毛窦的一些争议进行了汇总和... 详细信息

美国结直肠外科医师协会(The American Society of Colon and Rectal Surgeons,ASCRS)于2019年2月公布了最新的藏毛窦诊治临床实践指南。指南是由国际知名结直肠外科专家组成的临床实践指南委员会修订,对藏毛窦的一些争议进行了汇总和分析。

关键词：藏毛窦治疗指南美国结直肠外科医师协会循证医学

High-Throughput UAV Image-Based Method Is More Precise Than Manual Rating of Herbicide Tolerance

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Plant Phenomics 2019年第1期1卷 133-141页

作者： Hema S.N.Duddu eric N.johnson Christian *** Steven J.Shirtliffe Department of Plant Sciences College of Agriculture and BioresourcesUniversity of Saskatchewan51 Campus DriveSaskatoonSKCanada

The traditional visual rating system is labor-intensive,time-consuming,and prone to human *** aerial vehicle(UAV)imagery-based vegetation indices(VI)have potential applications in high-throughput plant *** study objective is to determine if UAV imagery provides accurate and consistent estimations of crop injury from herbicide application and its potential as an alternative to visual *** study was conducted at the kernen Crop Research Farm,University of Saskatchewan in 2016 and ***(Vicia faba L.)crop tolerance to nine herbicide tank mixtures was evaluated with 2 rates distributed in a randomized complete block design(RCBD)with 4 *** trial was imaged using a multispectral camera with a ground sample distance(GSD)of 1.2 cm,one week after the treatment *** ratings of growth reduction and physiological chlorosis were recorded simultaneously with *** optimized soil-adjusted vegetation index(OSAVI)was calculated from the thresholded *** UAV-based vegetation index(OSAVI)produced more precise results compared to visual ratings for both *** coefficient of variation(CV)of OSAVI was~1%when compared to 18-43%for the visual ***,Tukey’s honestly significance difference(HSD)test yielded a more precise mean separation for the UAV-based vegetation index than visual *** significant correlations between OSAVI and the visual ratings from the study suggest that undesirable variability associated with visual assessments can be minimized with the UAVbased ***-based imagery methods had greater precision than the visual-based ratings for crop herbicide *** methods have the potential to replace visual ratings and aid in screening crops for herbicide tolerance.

关键词： Visual precise replace

Quantifying foliar trait variation and covariation in sun and shade leaves using leaf spectroscopy in eastern North America

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Forest Ecosystems 2024年第5期11卷 728-742页

作者： Zhihui Wang Philip A.Townsend eric L.kruger Anna k.Schweiger Guangdong Provincial key Laboratory of Remote Sensing and Geographical Information System Guangdong Open Laboratory of Geospatial Information Technology and ApplicationGuangzhou Institute of GeographyGuangdong Academy of SciencesGuangzhou510070China Department of Forest and Wildlife Ecology University of Wisconsin-Madison1630 Linden DriveMadisonWI53706USA Department of Land Resources and Environmental Sciences Montana State University334 Leon Johnson HallBozemanMT59717USA

Characterizing foliar trait variation in sun and shade leaves can provide insights into inter-and intra-species resource use strategies and plant response to environmental ***,datasets with records of multiple foliar traits from the same individual and including shade leaves are sparse,which limits our ability to investigate trait-trait,trait-environment relationships and trait coordination in both sun and shade *** presented a comprehensive dataset of 15 foliar traits from sun and shade leaves sampled with leaf spectroscopy,including 424 individuals of 110 plant species from 19 sites across eastern North *** investigated trait variation,covariation,scaling relationships with leaf mass,and the effects of environment,canopy position,and taxonomy on trait ***,sun leaves had higher leaf mass per area,nonstructural carbohydrates and total phenolics,lower mass-based chlorophyll a+b,carotenoids,phosphorus,and potassium,but exhibited species-specific *** between sun and shade leaf traits,and trait-environment relationships were overall consistent across *** main dimensions of foliar trait variation in seed plants were revealed including leaf economics traits,photosynthetic pigments,defense,and structural *** and canopy position collectively explained most of the foliar trait *** study highlights the importance of including intra-individual and intra-specific trait variation to improve our understanding of ecosystem *** findings have implications for efficient field sampling,and trait mapping with remote sensing.

关键词： Foliar traits Leaf trait variation Trait-environment covariation Shade leaves NEON Leaf spectroscopy

Engineering Nannochloropsis oceanica for the production of diterpenoid compounds

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mLife 2023年第4期2卷 428-437页

作者： Zhi-Yan Du Wajid W.Bhat eric Poliner Sean johnson Conor Bertucci Eva Farre Bjoern Hamberger Department of Molecular Biosciences and Bioengineering University of Hawaii at ManoaHonoluluHawaiiUSA Department of Biochemistry and Molecular Biology Michigan State UniversityEast LansingMichiganUSA Department of Plant Biology Michigan State UniversityEast LansingMichiganUSA New England Biolabs Inc. 240 County Roadlpswich01938 MAUSA

Photosynthetic microalgae like Nannochloropsis hold enormous potential as sustainable,light-driven biofactories for the production of high-value natural products such as *** oceanica is distinguished as a particularly robust host with extensive genomic and transgenic resources *** capacity to grow in wastewater,brackish,and sea waters,coupled with advances in microalgal metabolic engineering,genome editing,and synthetic biology,provides an excellent *** the present work,we demonstrate how *** can be engineered to produce the diterpene casbene—an important intermediate in the biosynthesis of pharmacologically relevant macrocyclic *** accumulated after stably expressing and targeting the casbene synthase from Daphne genkwa(DgTPS1)to the algal *** engineered strains yielded production titers of up to 0.12 mg g^(−1) total dry cell weight(DCW)*** overexpression and chloroplast targeting of two upstream rate-limiting enzymes in the 2-C-methyl-d-erythritol 4-phosphate pathway,Coleus forskohlii 1-deoxy-d-xylulose-5-phosphate synthase and geranylgeranyl diphosphate synthase genes,further enhanced the yield of casbene to a titer up to 1.80 mg g^(−1) *** results presented here form a basis for further development and production of complex plant diterpenoids in microalgae.

关键词： casbene microalgae plastid targeting synthetic biology terpene synthase