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Salient concerns in using analgesia for cancer pain among outpatients: A cluster analysis study

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World j.urnal of Clinical Oncology 2017年第1期8卷 75-85页

作者： Salimah H Meghani george j.Knafl Department of Biobehavioral Health Sciences New Courtland Center for Transitions and HealthLeonard Davis Institute of Health EconomicsUniversity of Pennsylvania University of North Carolina at Chapel Hill School of Nursing

AIM To identify unique clusters of patients based on their concerns in using analgesia for cancer pain and predictors of the cluster *** This was a 3-mo prospective observational study(n = 207).Patients were included if they were adults(≥ 18 years), diagnosed with solid tumors or multiple myelomas, and had at least one prescription of around the clock pain medication for cancer or cancer-treatment-related *** were recruited from two outpatient medical oncology clinics within a large health system in Philadelphia.A choice-based conj.int(CBC) analysis experiment was used to elicit analgesic treatment preferences(utilities).Patients employed trade-offs based on five analgesic attributes(percent relief from analgesics, type of analgesic, type of sideeffects, severity of side-effects, out of pocket cost).Patients were clustered based on CBC utilities using novel adaptive statistical *** logistic regression was used to identify predictors of cluster *** The analyses found 4 unique clusters: Most patients made trade-offs based on the expectation of pain relief(cluster 1, 41%).For a subset, the main underlying concern was type of analgesic prescribed, i.e., opioid vs non-opioid(cluster 2, 11%) and type of analgesic side effects(cluster 4, 21%), *** one in four made trade-offs based on multiple concerns simultaneously including pain relief, type of side effects, and severity of side effects(cluster 3, 27.5%).In multivariable analysis, to identify predictors of cluster membership, clinical and socioeconomic factors(education, health literacy, income, social support) rather than analgesic attitudes and beliefs were found important; only the belief, i.e., pain medications can mask changes in health or keep you from knowing what is going on in your body was found significant in predicting two of the four clusters [cluster 1(-); cluster 4(+)].CONCLUSION Most patients appear to be driven by a single salient concer

关键词： Cancer pain Analgesia Opioids Preferences Conj.int analysis Side-effects

Considerations for bariatric surgery in patients with cirrhosis

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World j.urnal of Gastroenterology 2018年第28期24卷 3112-3119页

作者： george Boon-Bee Goh Philip R Schauer Arthur j.McCullough Department of Gastroenterology and Hepatology Singapore General HospitalSingapore 169608Singapore Duke-NUS Graduate Medical School Singapore 169608Singapore Bariatric and Metabolic Institute Cleveland ClinicClevelandOH 44195United States Department of Gastroenterology Cleveland ClinicClevelandOH 44195United States Department of Pathobiology Cleveland ClinicClevelandOH 44195United States

With the ever increasing global obesity pandemic, clinical burden from obesity related complications are anticipated in parallel. Bariatric surgery, a treatment approved for weight loss in morbidly obese patients, has reported to be associated with good outcomes, such as reversal of type two diabetes mellitus and reducing all-cause mortality on a long term basis. However, complications from bariatric surgery have similarly been reported. In particular, with the onslaught of non-alcoholic fatty liver disease(NAFLD) epidemic, in associated with obesity and metabolic syndrome, there is increasing prevalence of NAFLD related liver cirrhosis, which potentially connotes more risk of specific complications for surgery. Bariatric surgeons may encounter, either expectedly or unexpectedly, patients with non-alcoholic steatohepatitis(NASH) and NASH related cirrhosis more frequently. As such, the issues and considerations surrounding their medical care/surgery warrant careful deliberation to ensure the best outcomes. These considerations include severity of cirrhosis, liver synthetic function, portal hypertension and the impact of surgical factors. This review explores these considerations comprehensively and emphasizes the best approach to managing cirrhotic patients in the context of bariatric surgery.

关键词： Cirrhosis Portal hypertension Non-alcoholic fatty liver disease Bariatric surgery Complications

Single nucleotide polymorphisms of OCTN1, OCTN2, and DLG5 genes in Greek patients with Crohn's disease

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World j.urnal of Gastroenterology 2005年第47期11卷 7525-7530页

作者： Maria Gazouli Gerassimos Mantzaris Athanassios j.Archimandritis george Nasioulas Nicholas P Anagnou Department of Biology School of MedicineUniversity of AthensAthens 11725Greece Department of Gastroenterology Evagelismos HospitalAthens 11521Greece Department of Internal Medicine Hippokration General HospitalSchool of MedicineUniversity of AthensAthens 11527Greece Molecular Biology Department Research Center HYGEIA "Antonis Papayiannis" AthensGreece

AIM: To validate novel single nucleotide polymorphisms (SNPs) in Greek patients with Crohn's disease (CD).METHODS: A total of 120 patients with CD, 85 patients with UC, and 100 unrelated healthy controls were genotyped. Genotyping was performed by allele-specific PCR or by PCR-RFLP ***: Our results showed that the 1672T and -207C alleles were obviously over-represented in CD patients only (P＜0.01 and P＜0.05, respectively) compared to the control population. The G113A polymorphism was completely absent in our studied population. The odds ratio for the carriage of the TC haplotype was 2.21 for CD patients as compared with controls. Additionally, the frequency of the TC haplotype was increased in patients with ileocolitis or colitis, and was mainly associated with the fibrostenotic phenotype of the disease. Furthermore, when the TC haplotype was compared j.intly with the carriage of at least one mutation of the NOD2/CARD15 gene, there was an increased risk for CD, but not for UC, compared to controls. Regarding the location of the disease, the concomitant presence of the TC haplotype and NOD2/CARD15 mutations was mainly associated with ileocolitis or ileitis. CONCLUSION: Collectively, our results suggest that the 1672T variant of the OCTN1 gene and the -207C variant of the OCTN2 gene represent risk factors for CD in the Greek population.

关键词： Crohn's disease SNPs OCTN1 OCTN2 DLG5

Effects of glycaemic management on diabetic kidney disease

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World j.urnal of Diabetes 2017年第5期8卷 172-186页

作者： Richard j.MacIsaac george j.rums Elif I Ekinci Department of Endocrinology and Diabetes St Vincent’s Hospital Department of Medicine University of Melbourne Endocrine Centre Austin Health

Hyperglycaemia contributes to the onset and progression of diabetic kidney disease(DKD). Observational studies have not consistently demonstrated a glucose threshold, in terms of HbA1c levels, for the onset of DKD. Tight glucose control has clearly been shown to reduce the incidence of micro-or macroalbuminuria. However, evidence is now also emerging to suggest that intensive glucose control can slow glomerular filtration rate loss and possibly progression to end stage kidney disease. Achieving tight glucose control needs to be balanced against the increasing appreciation that glucose targets for the prevention of diabetes related complications need be individualised for each patient. Recently, empagliflozin which is an oral glucose lowering agent of the sodium glucose cotransporter-2 inhibitor class has been shown to have renal protective effects. However, the magnitude of empagliflozin's reno-protective properties are over and above that expected from its glucose lowering effects and most likely largely result from mechanisms involving alterations in intra-renal haemodynamics. Liraglutide and semaglutide, both inj.ctable glucose lowering agents which are analogues of human glucagon like peptide-1 have also been shown to reduce progression to macroalbuminuria through mechanisms that remain to be fully elucidated. Here we review the evidence from observational and interventional studies that link good glucose control with improved renal outcomes. We also briefly review the potential reno-protective effects ofnewer glucose lowering agents.

关键词： Diabetic nephropathy Albuminuria Glucose control Glomerular filtration rate Diabetes Chronic kidney disease Empagliflozin Liraglutide Semaglutide

Plant-frugivore interactions in an intact tropical forest in north-east Thailand

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Integrative Zoology 2011年第3期6卷 195-212页

作者： Wangworn SANKAMETHAWEE Andrew j.PIERCE george A.GALE Britta Denise HARDESTY Conservation Ecology Program School of Bioresources and TechnologyKing Mongkut’s University of Technology ThonburiBangkok Thailand Walai Rukhavej.Botanical Research Institute Mahasarakham UniversityMahasarakhamThailand CSIRO Ecosystem Sciences AthertonQueenslandAustralia

Fleshy-fruited plants in tropical forests largely rely on vertebrate frugivores to disperse their *** this plant-animal interaction is typically considered a diffuse mutualism,it is fundamental as it provides the template on which tropical forest communities are *** applied a mutualistic network approach to investigate the relationship between small-fruited fleshy plant species and the fruit-eating bird community in an intact evergreen forest in north-east Thailand.A minimum of 53 bird species consumed fruits of 136 plant ***-avian frugivore networks were highly asymmetrical,with observed networks filling 30%of all potential *** some of the missing links in the present study might be due to undersampling,forbidden links can be attributed to size constraints,accessibility and phenological uncoupling,and although the maj.rity of missing links were unknown(58.2%),many were probably due to a given bird species being either rare or only a very occasional fruit *** most common frugivores were bulbuls,barbets and fairy-bluebirds,which were responsible for the maj.rity of fruit removal from small fleshy fruited species in our *** birds seemed to be a minor component of the plant-frugivore networks,accounting for only 3%of feeding visits to fruiting trees;they filled 2%of the overall potential *** maj.rity of interactions were generalized unspecific;however,Saurauia roxburghii *** to be dependent on flowerpeckers for dispersal,while Thick-billed Pigeons were only seen to eat figs.

关键词： avian frugivore nestedness plant-frugivore networks seed dispersal tropical forest

Octreotide induces caspase activation and apoptosis in human hepatoma HepG2 cells

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World j.urnal of Gastroenterology 2011年第3期17卷 313-321页

作者： Nikos j.Tsagarakis Ioannis Drygiannakis Antonis G Batistakis george Kolios Elias A Kouroumalis Liver Research Laboratory School of MedicineUniversity of Crete Laboratory of Pharmacology School of MedicineDemocritus University of Thrace Department of Gastroenterology and Hepatology University Hospital of Heraklion

AIM: To investigate the role of octreotide on cellular proliferation and apoptosis of human hepatoma (HepG2) cells. METHODS: We studied cellular proliferation, apoptosis and the possible internal caspase-mediated apoptosis pathway involved, after treatment of HepG2 carcinoma cells with octreotide in comparison with the apoptosis caused by tumor necrosis factor-α (TNF-α). Activities of caspase-3, caspase-9, caspase-8 and caspase-2 were studied, while apoptosis was investigated through detection of DNA fragmentation and through identification of apoptotic cells with the annexin-V/propidium iodide flow cytometric method. RESULTS: After an initial increase in HepG2 cellular proliferation, a significant inhibition was observed with 10-8 mol/L octreotide, while TNF-α dose-dependently decreased proliferation. Early and late apoptosis was significantly increased with both substances. Octreotide significantly increased caspase-3, caspase-8 and caspase-2 activity. TNF-α signifi cantly increased only caspase-2. Cellular proliferation was decreased after treatment with octreotide or TNF-α alone but, in contrast to TNF-α, octreotide decreased proliferation only at concentrations of 10-8 mol/L, while lower concentrations increased proliferation. CONCLUSION: Our findings are suggestive of caspasemediated signaling pathways of octreotide antitumor activity in HepG2 cells, and indicate that measurements of serum octreotide levels may be important, at least in clinical trials, to verify optimal therapeutic drug concentrations.

关键词： Octreotide Hepatocellular carcinoma Apoptosis Caspases Somatostatin

Effects of study area size on home range estimates of common bottlenose dolphins Tursiops truncatus

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Current Zoology 2017年第6期63卷 693-701页

作者： Samantha R. NEKOLNY Matthew DENNY george BIEDENBACH Elisabeth M, HOWELLS Marilyn MAZZOIL Wendy N. DURDEN Lydia MORELAND j. DAVID LAMBErt Quincy A, GIBSON University of North Florida Department of Biology 1 UNF Drive Jacksonville FL 32224 USA Georgia Aquarium Conservation Field Station 9509 Oceanshore Blvd Saint Augustine FL 32080 USA Harbor Branch Oceanographic Institute at Florida Atlantic University 5600US-1 North Fort Pierce FL 32958 USA Hubbs-SeaWorld Research Institute 3830 South Highway AIA #4-181 Melbourne Beach FL 32951 USA Harbor Branch Oceanographic Institute at Florida Atlantic University 5600 US-1 North Fort Pierce FL 32958 USA.

Knowledge of an animal＇s home range is a crucial component in making informed management decisions. However, many home range studies are limited by study area size, and therefore may underestimate the size of the home range. In many cases, individuals have been shown to travel outside of the study area and utilize a larger area than estimated by the study design. In this study, data collected by multiple research groups studying bottlenose dolphins on the east coast of Florida were combined to determine how home range estimates increased with increasing study area size. Home range analyses utilized photo-identification data collected from 6 study areas throughout the St j.hns River （S j.; j.cksonville, FL, USA） and adj.cent waterways, extending a total of 253km to the southern end of Mosquito Lagoon in the Indian River Lagoon Estuarine System. Univariate kernel density estimates （KDEs） were computed for individuals with 10 or more sightings （n= 20）. Kernels were calculated for the primary study area （S j.） first, then additional kernels were calculated by combining the S j. and the next adj.cent waterway; this continued in an additive fashion until all study areas were included. The 95% and 50% KDEs calculated for the S j. alone ranged from 21 to 35 km and 4 to 19 kin, respectively. The 95% and 50% KDEs calculated for all combined study areas ranged from 116 to 217 km and 9 to 70 km, respectively. This study illustrates the degree to which home range may be underestimated by the use of limited study areas and demonstrates the benefits of conducting collaborative science.

关键词： bottlenose dolphin core area home range kernel analysis.

Analytical Modeling to Predict the Strain Energy of Circular GLARE Fiber-Metal Laminates Under Lateral Indentation

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材料科学与工程（中英文A版） 2013年第8期3卷 569-583页

作者： george j. Tsamasphyros george S. E. Bikakis Strength of Materials Laboratory National Technical University of Athens Athens 157 73 GR Greece

This article deals with the strain energy calculation of thin circular clamped Glass Reinforced (GLARE) fiber-metal laminates subj.cted to static indentation by a lateral hemispherical indentor. Using one-, two- and three-parameter Ritz approximations, analytical equations of the strain energy as a function of the central plate deflection are derived. Previously published analytical formulas, concerning the load-indentation response of circular GLARE plates, are used in order to determine the Ritz parameters and the first failure load and deflection due to tensile fracture of glass-epoxy layers. In this study, the membrane and bending strain energy components of aluminum and prepreg layers are determined. Also, the elastic and plastic strain energy absorbed during the indentation loading are calculated. The derived formulas are applied successfully for GLARE 2-2/1-0.3, GLARE 3-3/2-0.4 and GLARE 3I (special lay-up) circular plates subj.cted to lateral indentation. The strain energy results converge satisfactorily in all examined cases. The predicted strain energy-indentation response is compared with published experimental data and a good agreement is found. No other solution of this problem is known to the authors.

关键词：纤维金属层板弯曲应变能压痕预测建模解析公式金属层压板塑性应变能

Atypical group 1 neuraminidase pH1N1-N1 bound to a group 1 inhibitor

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Protein & Cell 2015年第10期6卷 771-773页

作者： Ying Wu Christopher j. Vavricka Yan Wu Qina Li Santosh Rudrawar Robin j.Thomson Mark yon Itzstein george F. Gao j.anxun Qi CAS Key Laboratory of Pathogenic Microbiology and Immunology Institute of Microbiology Chinese Academy of Sciences Beijing 100101 China Institute for Glycomics Griffith University Gold Coast Campus Nathan QLD 4222 Australia

Influenza virus is a member of the Orthomyxoviridae family and is the causative agent of seasonal and pandemic flu.

关键词： Influenza Influenza Virus Oseltamivir Plaque Reduction Assay I149V Mutant