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Unplanned hospitalizations for metastatic cancers:The changing patterns of inpatient palliative care,discharge to hospice care,and in-hospital mortality in the United States

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Family Medicine and Community Health 2017年第1期5卷 13-28页

作者： jason l.salemi Charles C.Chima Kiara K.Spooner Roger J.Zoorob Department of Family and Community Medicine Baylor College of MedicineHoustonTXUSA

Objective:To describe the rates and temporal trends of inpatient end-of-life care among patients hospitalized with metastatic cancer in the United ***:We used data from the Nationwide Inpatient Sample to conduct a cross-sectional analysis of unplanned inpatient hospitalizations of patients aged 18 years or older with metastatic cancer from 2002 to *** logistic regression was used to assess patient-and hospital-level predictors of discharge to hospice care,palliative care,and in-hospital *** trends in outcomes were characterized with use of joinpoint ***:There were an estimated 350,241 unplanned hospitalizations per year of patients with a diagnosis of metastatic *** their inpatient stay,5.8%of patients received palliative care,and among those discharged alive,12.2%were referred to hospice *** rate of inpatient palliative care increased from 2.3%to 13.6%,the rate of discharge to hospice care increased from 4.1%to 15.6%,and the in-hospital mortality rate decreased from more than 14.0%to 9.8%.These patterns were consistent across cancer subtypes,and were most pronounced among patients with extreme risk of ***:Despite increases in the provision of comfort-oriented care to patients with meta-static cancer,few receive such *** recommend screening protocols in hospitals to identify patients who are good candidates for palliative care consultation and hospice referral.

关键词： End-of-life hospice care inpatient mortality metastatic cancer palliative care unplanned hospitalization

Modified Advanced life Support in Obstetrics course: Feasibility, trainee satisfaction, and sustainability potential

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Family Medicine and Community Health 2017年第1期5卷 71-77页

作者： Anjali Aggarwal jason l.salemi Bernice Yap Jennifer l.Matas Sameer Naik Roger J.Zoorob Hamisu M.Salihu Department of Family and Community Medicine Baylor College of MedicineHoustonTXUSA College of Public Health University of South FloridaTampaFLUSA

Objective:The main objective of this initiative was to present evaluation results from an inno-vative adaptation of the Advanced life Support in Obstetrics(AlSO)training *** modified the traditional AlSO curriculum in our institution by adding hands-on training in laceration repairs and simulation scenarios on acute maternity ***:The modified AlSO provider course was designed to enhance cognitive and proce-dural skills of health care professionals in managing obstetric ***-nine participants attended this course and completed a posttraining *** statistics were used to de-scribe the participant-reported assessment scores for the AlSO course on three domains(subject knowledge,organization and clarity,and teaching effectiveness)for each of 12 course ***:Evaluation of the results showed a high rate of trainee satisfaction as evidenced by the mean assessment scores across all topics ranging from 4.80 to 4.98(out of 5.00).All trainees said they would refer others to the *** modified AlSO course effectively addressed the important needs of primary care physicians involved in maternity care,especially in underserved communities where specialized obstetric care is not readily *** simulation scenarios and workshops using simulated human tissue provide a better foundation before formal ***:Given the changing legal and regulatory climate,we expect that learning to treat complex obstetric situations on the job will become increasingly *** this in mind,both simulation scenarios and workshops using simulated human tissue will provide a better foundation before formal training.

关键词： Advanced life Support in Obstetrics(AlSO) training hands-on laceration re-pair simulated human tissue

Hospitalizations and healthcare costs associated with serious, non-lethal firearm-related violence and injuries in the United States, 1998-2011

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Family Medicine and Community Health 2015年第2期3卷 8-19页

作者： jason l.salemi Vikas Jindal RoneéE.Wilson Mulubrhan F.Mogos Muktar H.Aliyu Hamisu M.Salihu Department of Family and Community Medicine Baylor College of MedicineHoustonTexasUSA Department of Occupational Health Kaiser PermanenteLancasterCaliforniaUSA Department of Epidemiology and Biostatistics College of Public HealthUniversity of South FloridaTampaFloridaUSA Department of Community Health Systems School of NursingIndiana UniversityIndianapolisIndianaUSA Vanderbilt Institute for Global Health Vanderbilt UniversityNashvilleTennesseeUSA

Objective:To describe the prevalence,trends,correlates,and short-term outcomes of inpa-tient hospitalizations for firearm-related injuries(FRIs)in the United States between 1998 and ***:We conducted a retrospective,cross-sectional analysis of inpatient hospitalizations using data from the Nationwide Inpatient *** addition to generating national prevalence estimates,we used survey logistic regression to calculate odds ratios(ORs)and 95%confidence intervals(CIs)for the association between FRIs and patient/hospital-level ***-ral trends were estimated and characterized using joinpoint ***:There were 10.5 FRIs(95%CI:9.2-11.8)per 10,000 non-maternal/neonatal inpatient hospitalizations,with assault accounting for 60.1%of FRIs,followed by unintentional/accidental(23.0%)and intentional/self-inflicted FRIs(8.2%).The highest odds of FRIs,particularly FRIs associated with an assault,was observed among patients 18-24 years of age,patients 14-17 years of age,patients with no insurance/self-pay,and non-Hispanic *** mean inpatient length of stay for FRIs was 6.9 days;however,4.7%of patients remained in the hospital over 24 days and 1 in 12 patients(8.2%)died before *** mean cost of an inpatient hospitalization for a FRI was$22,149,which was estimated to be$679 million annually;approximately two-thirds of the annual cost(64.7%)was for assault($439 million).Conclusion:FRIs are a preventable public health issue which disproportionately impacts younger generations,while imposing significant economic and societal burdens,even in the ab-sence of *** of FRIs should be considered a priority in this era of healthcare cost containment.

关键词： Assault cost gunshot firearms hospitalization intentional injury

Degradation and resynthesis of chlorophyll during increased oxidative stress and prolonged darkness differ between annual and perennial flax(linum l.)

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Oil Crop Science 2024年第2期9卷 121-130页

作者： Kenyon J. Nisbett Abida Alokozai Su Hyun Elizabeth Ko G. Adam Mott jason C.l. Browna Department of Biological Sciences University of Toronto ScarboroughTorontoONCanada Department of Cell&Systems Biology University of TorontoTorontoONCanada Centre for the Analysis of Genome Evolution&Function University of TorontoTorontoONCanada

Among plants,there is considerable variation in lifespan:annuals live less than one year,whereas perennials live for several years,with the longest-living perennial having survived 43,600 *** proposed by the Disposable Soma Theory,this lifespan variation among plants likely reflects differential investment of limited energy and nutrient resources,with perennials investing more energy and nutrients into biomolecular maintenance compared to annuals in order to ensure persistence over multiple *** differential investment may be particularly important during periods of exogenous stress,which are known to accelerate biomolecular *** present study evaluated this hypothesis using annual and perennial flax(linum l.)subjected to two exogenous stressors—increased oxidative stress(i.e.,foliar H2O2spraying)and complete prolonged *** chlorophyll has been shown to exhibit degradation in response to changes in environmental conditions,we utilized changes in chlorophyll levels during and after periods of exogenous stress to evaluate our *** predicted that i)perennials would exhibit a slower rate of chlorophyll degradation during exposure to exogenous stressors compared to annuals,and ii)perennials would exhibit a faster rate of chlorophyll resynthesis following such exposure compared to *** levels before,during,and after exposure to both exogenous stressors were measured in two separate trails,once using image colour analysis and once using *** chlorophyll degradation rates in response to oxidative stress did not differ between annuals and perennials,contrary to our predictions,chlorophyll resynthesis rates following such exposure were significantly higher in perennials,as *** plants were subjected to complete prolonged darkness,chlorophyll degradation rates were significantly lower in perennials than annuals,as predicted;however,when plants were subsequently reintroduced to natural photoperiod,ch

关键词： Ageing life history Maximum lifespan Oxidative stress Somatic maintenance

Canonical and noncanonical Wnt signaling: Multilayered mediators, signaling mechanisms and major signaling crosstalk

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Genes & Diseases 2024年第1期11卷 103-134页

作者： Kevin Qin Michael Yu Jiaming Fan Hongwei Wang Piao Zhao Guozhi Zhaoo Wei Zeng Connie Chen Yonghui Wang Annie Wang Zander Schwartz Jeffrey Hong lily Song William Wagstaff Rex C.Haydon Hue H.luu Sherwin H.Ho jason Strelzow Russell R.Reid Tong-Chuan He lewis l.Shi Chicago Medical School Rosalind Franklin University of Medicine and ScienceNorth ChicagoIL 60064USA Molecular Oncology laboratory Department of Orthopaedic Surgery and Rehabilitation MedicineThe University of Chicago Medical CenterChicagoIL 60637USA Ministry of Education Key laboratory of Diagnostic Medicine and Department of Clinical BiochemistryThe School of Laboratory MedicineChongqing Medical UniversityChongqing 400016China Departments of Orthopaedic Surgery and Urology The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of Interventional Neurology The First Dongguan Affiliated HospitalGuangdong Medical UniversityDongguanGuangdong 523475China Department of Clinical laboratory Medicine Shanghai Jiaotong University School of MedicineShanghai 200000China School of Biomedical Engineering Vanderbilt UniversityNashvilleTN 37235USA laboratory of Craniofacial Biology and Development Department of Surgery Section of Plastic SurgeryThe University of Chicago Medical CenterChicagoIL 60637USA

Wnt signaling plays a major role in regulating cell proliferation and *** Wnt ligands are a family of 19 secreted glycoproteins that mediate their signaling effects via binding to Frizzled receptors and lRP5/6 coreceptors and transducing the signal either throughβ-catenin in the canonical pathway or through a series of other proteins in the nonca-nonical *** of the individual components of both canonical and noncanonical Wnt signaling have additional functions throughout the body,establishing the complex interplay between Wnt signaling and other signaling *** crosstalk between Wnt signaling and other pathways gives Wnt signaling a vital role in many cellular and organ ***-regulation of this system has been implicated in many diseases affecting a wide array of organ systems,including cancer and embryological defects,and can even cause embryonic *** complexity of this system and its interacting proteins have made Wnt signaling a target for many therapeutic ***,both stimulatory and inhibitory treatments come with potential risks that need to be *** review synthesized much of the current knowl-edge on the Wnt signaling pathway,beginning with the history of Wnt *** thoroughly described the different variants of Wnt signaling,including canonical,noncanonical Wnt/PCP,and the noncanonical Wnt/Ca2+*** description involved each of its components and their involvement in other cellular ***,this review explained the various other pathways and processes that crosstalk with Wnt signaling.

关键词： β-catenin Canonical Wnt Noncanonical Wnt Signal transduction Signaling crosstalk

Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： jason Philip Appleton lisa J Woodhouse Craig S Anderson Sandeep Ankolekar lesley Cala Mark Dixon Timothy J England Kailash Krishnan Grant Mair Keith W Muir John Potter Christopher I Price Marc Randall Thompson G Robinson Christine Roffe Else C Sandset Jeffrey l Saver Angela Shone Aloysius Niroshan Siriwardena Joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NIHR leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS AlREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random

Dynamics of self-hybridized exciton–polaritons in 2D halide perovskites

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light(Science & Applications) 2024年第1期13卷 13-22页

作者： Surendra B.Anantharaman jason lynch Christopher E.Stevens Christopher Munley Chentao li Jin Hou Hao Zhang Andrew Torma Thomas Darlington Francis Coen Kevin li Arka Majumdar PJames Schuck Aditya Mohite Hayk Harutyunyan Joshua R.Hendrickson Deep Jariwala Department of Electrical and Systems Engineering University of PennsylvaniaPhiladelphiaPA19104USA KBR Inc. BeavercreekOH45431USA Air Force Research laboratory Sensors DirectorateWright-Patterson Air Force BaseOH45433USA Department of Physics University of WashingtonSeattleWA98195USA Department of Physics Emory UniversityAtlantaGA30322USA Department of Chemical and Biomolecular Engineering Rice UniversityHoustonTX77005USA Department of Materials Science and Nanoengineering Rice UniversityHoustonTX77005USA Applied Physics Program Smalley‐Curl InstituteRice UniversityHoustonTX77005USA Department of Mechanical Engineering Columbia UniversityNew YorkNY10027USA Department of Electrical and Computer Engineering University of WashingtonSeattleWA98195USA

Excitons,bound electron–hole pairs,in two-dimensional hybrid organic inorganic perovskites(2D HOIPs)are capable of forming hybrid light-matter states known as exciton-polaritons(E–Ps)when the excitonic medium is confined in an optical *** the case of 2D HOIPs,they can self-hybridize into E–Ps at specific thicknesses of the HOIP crystals that form a resonant optical cavity with the ***,the fundamental properties of these self-hybridized E–Ps in 2D HOIPs,including their role in ultrafast energy and/or charge transfer at interfaces,remain ***,we demonstrate that>0.5µm thick 2D HOIP crystals on Au substrates are capable of supporting multiple-orders of self-hybridized E–P *** E–Ps have high Q factors(>100)and modulate the optical dispersion for the crystal to enhance sub-gap absorption and *** varying excitation energy and ultrafast measurements,we also confirm energy transfer from higher energy E–Ps to lower energy E–***,we also demonstrate that E–Ps are capable of charge transport and transfer at *** findings provide new insights into charge and energy transfer in E–Ps opening new opportunities towards their manipulation for polaritonic devices.

关键词： charge polar excitation

Elite,transformable haploid inducers in maize

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The Crop Journal 2024年第1期12卷 314-319页

作者： Brent Delzer Dawei liang David Szwerdszarf Isadora Rodriguez Gonzalo Mardones Sivamani Elumalai Francine Johnson Samson Nalapalli Rachel Egger Erin Burch Kerry Meier Juan Wei Xiujuan Zhang Huaping Gui Huaibing Jin Huan Guo Kun Yu Yubo liu Becky Breitinger Ana Poets jason Nichols Wan Shi David Skibbe Qiudeng Que Timothy Kelliher Seeds Development Syngenta SeedsJanesvilleWI 53546USA Seeds Research Syngenta Biotechnology China Co.Ltd.Beijing 102206China Centro de Investigación de Cultivos Arica Syngenta R&DArica 1000000Chile Syngenta S.A. Proyecto la SoledadGraneros 2880000Chile Seeds Research Syngenta Crop Protection LLCRTPNC 27709USA Seeds Development Syngenta SeedsSlaterIA 50244USA

The introduction of alleles into commercial crop breeding pipelines is both time consuming and *** technologies that are disrupting traditional breeding processes are doubled haploid(DH)breeding and genome editing(GE).Recently,these techniques were combined into a GE trait delivery system called HI-Edit(Haploid Inducer-Edit).In HI-Edit,the pollen of a haploid inducer line is reprogrammed to deliver GE traits to any variety,obviating recurrent *** HI-Edit to operate at scale,an efficient transformable HI line is needed,but most maize varieties are recalcitrant to transformation,and haploid inducers are especially difficult to transform given their aberrant reproductive *** marker assisted selection and a three-tiered testing scheme,we report the development of new Iodent and Stiff Stalk maize germplasm that are transformable,have high haploid induction rates,and exhibit a robust,genetically-dominant anthocyanin native trait that may be used for rapid haploid *** show that transformation of these elite‘‘HI-Edit”lines is enhanced using the BABYBOOM and WUSCHEl morphogenetic ***,we evaluate the HI-Edit performance of one of the lines against both Stiff Stalk and non-Stiff Stalk *** strategy and results of this study should facilitate the development of commercially scalable HI-Edit systems in diverse crops.

关键词： Zea mays l Doubled haploids Transformation Genome editing QTl

Surgery for metastatic pancreatic neuroendocrine tumors: a narrative review

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Hepatobiliary Surgery and Nutrition 2023年第1期12卷 69-83页

作者： Jelani K.Williams jason l.Schwarz Xavier M.Keutgen Division of General Surgery and Surgical Oncology Department of SurgeryUniversity of Chicago MedicineChicagoILUSA

Background and Objective:Pancreatic neuroendocrine tumors(PanNETs)are derived from the islet cells of the pancreas and have been increasing in *** of these tumors are nonfunctional although some can secrete hormones and lead to hormone-specific clinical *** is the mainstay of treatment for localized tumors,however,surgical resection is controversial in metastatic *** narrative review seeks to summarize the current literature surrounding surgery,specifically in the controversial area of metastatic PanNETs,review current treatment paradigms,and understand the benefits of surgery in this group of ***:Authors searched PubMed using the terms“surgery pancreatic neuroendocrine tumor”,“metastatic neuroendocrine tumor”,and“liver debulking neuroendocrine tumor”from January 1990 to June *** English language publications were *** Content and Findings:There is no consensus among the leading specialty organizations regarding surgery for metastatic *** considering surgery for metastatic PanNETs,tumor grade and morphology,location of the primary tumor,extra-hepatic or extra-abdominal disease,as well as liver tumor burden and metastatic distribution should be *** the liver is the most common site of metastasis and liver failure is the most common cause of death in patients with hepatic metastases,attention is centered here on debulking and other ablative *** transplantation is rarely used for hepatic metastases but could be beneficial in a small subset of *** studies have demonstrated improvement in survival and symptoms after surgery for metastatic disease,but the lack of prospective randomized control trials significantly limits analysis of surgical benefits in patients with metastatic ***:Surgery is the standard of care for localized PanNETs,while it remains controversial in metastatic *** studies have shown a survival and symptomatic be

关键词： Pancreatic neuroendocrine tumors(PanNETs) liver tumor burden hepatic metastasis liver debulking DOTATATE