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Oesophageal adenocarcinoma:In the era of extended lymphadenectomy,is the value of neoadjuvant therapy being attenuated?

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World Journal of Gastrointestinal Surgery 2021年第10期13卷 1235-1244页

作者： Jin-Soo Park Hans Van der Wall Catherine kennedy Gregory L Falk Upper GI Surgery Concord Repatriation General HospitalSydney 2137NSWAustralia Department of Medicine University of Notre DameSydney 2007NSWAustralia CNI Molecular Imaging Notre Dame UniversitySydney 2114NSWAustralia

BACKGROUND Neoadjuvant chemotherapy(NACT)and oesophagectomy is the standard of care for resectable oesophageal *** outcomes following resection have been improving over time while NACT remain largely ***,a recent meta-analysis of randomized control trials did not demonstrate a survival benefit in adding NACT,raising the possibility that improved surgical techniques may be reducing the perceived effectiveness of *** To compare the effect of addition of NACT to a standardized surgery and lymphadenectomy on overall and disease-free survival in patients undergoing curative oesophagectomy for oesophageal *** Patient data were analysed from a prospectively maintained surgical survival ***,surgical,and survival outcomes were compared between groups according to treatment and nodal *** The data of 243 consecutive patients were identified.79 patients were given NACT and 162 had surgery *** NACT group were younger,and there was less frequent stage I *** survival was similar between NACT and surgery only groups(5YS:48.7%vs 42.5%;P=0.113),as was diseasefree survival(5YS:40.6%vs 39.9%;P=0.635).There were≥30 nodes removed in 46 patients,and<30 in 197 patients,but were otherwise *** was improved survival in patients with≥30 nodes removed than those with<30 nodes(5YS:64.4%vs 40.7%;P=0.015),and a better disease-free survival that neared significance(5YS:54.9%vs 36.6%;P=0.078).CONCLUSION NACT did not appear to affect overall or disease-free ***,an overall survival benefit was observed in patients with≥30 lymph nodes removed,and a benefit in disease-free survival which was not significant.

关键词： Oesophagectomy Oesophageal adenocarcinoma Neoadjuvant chemotherapy Lymphadenectomy Survival outcome Surgical technique

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ECMO in major burn patients: feasibility and considerations when multiple modes of mechanical ventilation fail

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Burns & Trauma 2017年第2期5卷 134-139页

作者： Jason D. kennedy Wesley Thayer Reuben Beuno Kelly Kohorst Avinash B. Kumar Department of Anesthesiology and Critical Care Vanderbilt University Medical Center 121121st Avenue S Suite 526 Nashville TN 37212 USA Department of Plastic Surgery Vanderbilt University Nashville TN USA

Background: We report two cases of acute respiratory distress syndrome in burn patients who were successfully managed with good outcomes with extra corporeal membrane oxygenation (ECMO) after failing multiple conventional modes of ventilation, and review the relevant *** presentation: The two patients were a 39-year-old male and 53-year-old male with modified Baux Scores of 79 and 78, respectively, with no known inhalation injury. After the initial modified Parkland-based fluid resuscitation and partial escharotomy, both patients developed worsening hypoxemia and acute respiratory distress *** hypoxemia continued to worsen on multiple modes of ventilation including volume control, pressure regulated volume control, pressure control, airway pressure release ventilation and volumetric diffusive *** both cases, the PaO2 ≤ 50 mm Hg on a FiO2100% during the trial of mechanical ventilation. The deterioration was rapid (<12 h since onset of worsening oxygenation) in both cases.A decision was made to trial the patients on ECMO. Veno-Venous ECMO (V-V ECMO) was successfully initiated following cannulation-under transesophgeal echo guidance—with the dual lumen Avalon? (Maquet, NJ, USA) cannula. ECMO support was maintained for 4 and 24 days, respectively. Both patients were successfully weaned off ECMO and were discharged to rehabilitation following their complex hospital ***: Early ECMO for isolated respiratory failure in the setting on maintained hemodynamics resulted in a positive outcome in our two burn patients suffered from acute respiratory distress syndrome.

关键词： ARDS Burns Extra corporeal membrane oxygenation Rescue ventilation Conventional ventilation failure Veno-venous ECMO

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Ankle arthrodesis:A systematic approach and review of the literature

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World Journal of Orthopedics 2016年第11期7卷 700-708页

作者： Youichi Yasui Charles P Hannon Dexter Seow John G kennedy Hospital for Special Surgery Department of Orthopaedic Surgery 2~(nd) Teikyo University School of Medicine

Ankle arthrodesis is a common treatment used for patients with end-stage ankle arthritis(ESAA). The surgical goal of ankle arthrodesis is to obtain bony union between the tibia and talus with adequate alignment [slight valgus(0°-5°)], neutral dorsiflexion, and slight external rotation positions) in order to provide a pain-free plantigrade foot for weightbearing activities. There are many variations in operative technique including deferring approaches(open or arthroscopic) and differing fixation methods(internal or external fixation). Each technique has its advantage and disadvantages. Success of ankle arthrodesis can be dependent on several factors, including patient selection, surgeons' skills, patient comorbidities, operative care, etc. However, from our experience, the majority of ESAA patients obtain successful clinical outcomes. This review aims to outline the indications and goals of arthrodesis for treatment of ESAA and discuss both open and arthroscopic ankle arthrodesis. A systematic step by step operative technique guide is presented for both the arthroscopic and open approaches including a postoperative protocol. We review the current evidence supporting each approach. The review finishes with a report of the most recent evidence of outcomes after both approaches and concerns regarding the development of hindfoot arthritis.

关键词： Ankle Osteoarthritis Arthrodesis Review Ankle fusion

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Speech by Annette kennedy, President of International Council of Nurses at Leadership for Change Programme Launching Ceremony in Beijing 2017

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International Journal of Nursing Sciences 2017年第3期4卷 215-216页

作者： Annette kennedy International Council of Nurses

Good morning, Ms Yanhong Guo, Deputy Director of Medical Administration, NHFPC, Dr Xiuhua Li, President of CNA, Board members, Mr Edward Zhou, General Manager Ethicon and Johnson & Johnson Representatives, Regional CNA representatives, ICN trainers, Marcia Petrini & Kristine Qureshi, and all the program participants, and other guests.

关键词： Beijing Director Programme

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Who Made the Olympic Rings?

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考试(双语读写) 2012年第9期 40-41页

作者： Pagan kennedy

皮埃尔·德·顾拜旦男爵(Baron Pierre de Coubertin)是现代奥林匹克运动会的创始人。他是一位法国贵族,脸上留着浓密的、好像上过蜡似的小胡子,看起来像是个重音符号。1914年,这位男爵宣布他为纪念现代奥林匹克运动会20周年设计了一个... 详细信息

皮埃尔·德·顾拜旦男爵(Baron Pierre de Coubertin)是现代奥林匹克运动会的创始人。他是一位法国贵族,脸上留着浓密的、好像上过蜡似的小胡子,看起来像是个重音符号。1914年,这位男爵宣布他为纪念现代奥林匹克运动会20周年设计了一个标志。"这真的可以称得上是一个国际性的标志,"他描述说,这个标志以五个圆环为素材,相套连成一体,象征着人类团结。那么,男爵的灵感是从哪里获得的呢?1984年,体育历史学家罗伯特·巴尼(Robert Barney)正在勘察一处希腊考古遗迹,当他俯身系鞋带时,注意到

关键词：现代奥林匹克运动会顾拜旦历史学家 Who Made the Olympic Rings 皇位继承奥运五环

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Sensitivity of miRNA-181a,miRNA-23b and miRNA-16 in the Late-Onset Neonatal Sepsis:A Diagnostic Study

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Maternal-Fetal Medicine 2024年第4期6卷 243-248页

作者： Divya Katta Kopula Satyamoorthy Sridharan Uma Maheswari Balakrishnan Prakash Amboiram kennedy Kumar Department of Microbiology Sri Ramachandra Institute of Higher Education and ResearchPorurChennai 600116India Department of Neonatology Sri Ramachandra Institute of Higher Education and ResearchPorurChennai 600116India.

Objective To evaluate the expression and diagnostic value of levels of the microRNAs(miRNAs),miRNA-181a,miRNA-23b,and miRNA-16,in late-onset neonatal sepsis(LOS)and compare them with the diagnostic utility of C-reactive protein(CRP)*** This was a prospective diagnostic study conducted between January 2021 and March 2023 at a tertiary care center(Sri Ramachandra Hospital)in *** real-time polymerase chain reaction was performed to determine miRNA-181a,miRNA-23b,and miRNA-16 expression levels,and CRP was measured by *** diagnostic value of miRNA and CRP levels were analyzed using receiver operating characteristic(ROC)*** curves were utilized to determine optimal cutoff points,and Mann–Whitney tests were performed using SPSS to ascertain P values,with statistical significance defined as<*** This study included 100 samples,with 50 cases of culture-proven LOS(27 females,23 males)and 50 healthy controls(31 females,19 males).In LOS,miRNA-181a and miRNA-23b expression levels were significantly downregulated(P<0.001),with area under the curve(AUC)values of 0.83 and 0.92,respectively,whereas those of miRNA-16 were significantly upregulated(P<0.001;AUC=0.97).In comparison,CRP levels had an AUC value of 0.831(P<0.001).Further,miRNA-23b showed the highest sensitivity(98%)of markers tested,whereas miRNA-16 exhibited the highest specificity(96%).Conclusion MiRNA,especially miRNA-16,shows diagnostic potential for neonatal sepsis compared with traditional biomarkers like CRP and procalcitonin,suggesting its use as an early marker for ***,further cohort studies are needed before practical application.

关键词： MicroRNAs Real-time PCR Blood culture Biomarkers Late-onset sepsis

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Assessment of the usefulness of integrated disease surveillance and response on suspected ebola cases in the Brong Ahafo Region, Ghana

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Infectious Diseases of Poverty 2015年第1期4卷 168-175页

作者： Kofi Issah kennedy Nartey Richard Amoah Emmanuel George Bachan Jacob Aleeba Enuamah Yeetey Timothy Letsa Ghana Health Service Regional Health DirectorateP.O.Box 145SunyaniBrong Ahafo RegionGhana Kintampo Health Centre Ghana Health ServiceKintampoBrong Ahafo RegionGhana

Background:This study assessed the quality,core and support functions of the integrated disease surveillance and response(IDSR)system relating to 18 suspected cases of Ebola virus disease(EVD)in the Brong Ahafo Region,***:Data was collected on selected indicators of the surveillance system relating to 18 suspected cases of EVD,from epidemiological week 19 to 45 of *** conducted in-depth interviews with seven medical directors and two district directors of health services,and also reviewed documentation on the implementation of the core,support and quality functions of the IDSR *** also monitored news in the media and rumours about EVD within the community as well as in health facility surveillance ***:The study identified gaps in the implementation of IDSR relating to 18 suspected cases of *** staff heavily relied on haemorrhage as the only symptom for detection of suspected EVD *** blood samples and a swab of secretions from the mouth of the thirteenth patient(who died)tested negative for EVD using PCR assay in laboratory *** blood samples of three patients were discarded,as they did not fit the case definition for suspected cases,whilst two refused for their blood samples to be *** community-based surveillance(CBS)system has not been given a prominent role in EVD surveillance and response,as demonstrated by CBS volunteers and health staff not receiving any training in these *** was intense public interest in EVD in August and September *** interest has since waned for reasons that have to be formally *** fear of and anxiety about EVD still remain challenges due to a lack of in-depth knowledge about the disease in ***:Ghana has been one of the pioneers in the implementation of IDSR in *** this,gaps have been identified in the implementation of IDSR relating to EVD in the Brong Ahafo *** address these gaps,the CBS system has to activ

关键词： Ebola Disease surveillance Brong Ahafo Ghana

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Driving an Attractive Option

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ChinAfrica 2012年第8期4卷 30-31页

作者： kennedy Senelwa Chinese vehicle manufacturers firmly behind the wheel in East Africa

FOTON Motors East Africa Ltd. is investing $10 million in an automobile assembly plant in Nairobi at a time when Chinese vehicles are making inroads into Kenya.

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An antibody present in everybody that attacks malaria infected erythrocytes

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Journal of Biomedical Science and Engineering 2013年第7期6卷 1-3页

作者： James kennedy Manatee Memorial Hospital Bradenton USA

These malaria targeting antibodies are band 3 antibodies and they recognize a special configuration of a molecule called band 3 that is present on erythrocytes. The special band 3 configuration is present on the surface of senescent erythrocytes, malaria infected erythrocytes, the erythrocytes of certain hemoglobinnopathies such as sickle cell disease and on the erythrocytes of some metabolic disorders such as G6PD. Note that these hemoglobinopathies and metabolic disorders all aid in the survival of falciparum malaria to such an extent that their incidence is increased in falciparum endemic areas [1-3]. Though there are many adhesive molecules involved in the pathology of falciparum malaria and sickle cell anemia, the focus here is on the band 3 molecules.

关键词： Band 3 Malaria Sickle

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Current management of talar osteochondral lesions

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World Journal of Orthopedics 2017年第1期8卷 12-20页

作者： Arianna L Gianakos Youichi Yasui Charles P Hannon John G kennedy Department of Orthopedic Surgery 2~(nd) Jersey City Medical Center Department of Foot and Ankle Hospital for Special Surgery Department of Orthopaedic Surgery 2~(nd) Teikyo University School of Medicine 2~(nd) Department of Orthopaedic Surgery Rush University Medical Center (C.P.H.)

Osteochondral lesions of the talus(OLT) occur in up to 70% of acute ankle sprains and fractures. OLT have become increasingly recognized with the advancements in cartilage-sensitive diagnostic imaging modalities. Although OLT may be treated nonoperatively, a number of surgical techniques have been described for patients whom surgery is indicated. Traditionally, treatment of symptomatic OLT have included either reparative procedures, such as bone marrow stimulation(BMS), or replacement procedures, such as autologous osteochondral transplantation(AOT). Reparative procedures are generally indicated for OLT < 150 mm^2 in area. Replacement strategies are used for large lesions or after failed primary repair procedures. Although shortand medium-term results have been reported, longterm studies on OLT treatment strategies are lacking. Biological augmentation including platelet-rich plasma and concentrated bone marrow aspirate is becoming increasingly popular for the treatment of OLT to enhance the biological environment during healing. In this review, we describe the most up-to-date clinical evidence of surgical outcomes, as well as both the mechanical and biological concerns associated with BMS and AOT. In addition, we will review the recent evidence for biological adjunct therapies that aim to improve outcomes and longevity of both BMS and AOT procedures.

关键词： Osteochondral lesions of talus Comprehensive review Diagnosis Bone marrow stimulation Autologous autograft transfer Biologics

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