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De-novo hepatocellular carcinoma after pediatric living donor liver transplantation

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World Journal of Hepatology 2017年第36期9卷 1361-1366页

作者： Samuel Torres-landa Armando Salim Munoz-Abraham Brett E Fortune Ananta Gurung jeffrey Pollak Sukru H Emre Manuel I Rodriguez-Davalos Michael l Schilsky Department of Gastrointestinal Surgery Hospital of the University of Pennsylvania Department of Surgery Yale University School of Medicine Division of Gastroenterology and Hepatology Weill Cornell Medicine Department of Pathology Royal Columbian Hospital Department of Radiology and Biomedical Imaging Yale University School of Medicine Division of Digestive Diseases and Transplant and Immunology Department of Medicine and Surgery Yale University School of Medicine

De-novo malignancies carry an incidence ranging between 3%-26% after transplant and account for the second highest cause of post-transplant mortality behind cardiovascular disease. While the majority of de-novo malignancies after transplant usually consist of skin cancers, there has been an increasing rate of solid tumor cancers over the last 15 years. Although, recurrence of hepatocellular carcinoma(HCC) is well understood among patients transplanted for HCC, there are increasing reports of de-novo HCC in those transplanted for a non-HCC indication. The proposed pathophysiology for these cases has been mainly connected to the presence of advanced graft fibrosis or cirrhosis and always associated with the presence of hepatitis B or C virus. We report the first known case of de-novo HCC in a recipient, 14 years after a pediatric living related donor liver transplantation for end-stage liver disease due to biliary atresia without the presence of hepatitis B or C virus before and after transplant. We present this case report to increase the awareness of this phenomenon and address on the utility for screening and surveillance of hepatocellular carcinoma among these individuals. One recommendation is to use similar guidelines for screening, diagnosis, and treatment for HCC as those used for primary HCC in the pre-transplant patient, focusing on those recipients who have advanced fibrosis in the allograft, regardless of etiology.

关键词： liver transplantation De-novo hepatocellular carcinoma living donor liver transplantation Biliary atresia

2-Octyl Cyanoacrylate Skin Adhesive for Topical Skin Incision Closure in Female Pelvic Surgery

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Open Journal of Obstetrics and Gynecology 2015年第5期5卷 280-285页

作者： Rebecca l. James Marilyn Alejandro-Rodriquez Elba Adriana Perez jeffrey Mangel MetroHealth Medical Center Cleveland OH USA

Background: 2-octyl cyanoacrylate (2OCA) high viscosity tissue adhesive (Medline Industries, Inc., Mundelein, Il) is a liquid topical skin adhesive. 2OCA offers the same design features and clinical utility in terms of flexibility, strength, and low complication rate as the commercially available 2OCA tissue adhesives. Additionally, 2OCA features high viscosity allowing for better control during the application process, polymerization without the use of an external activator, and a distinctive violet color for ease of application visualization. Objective: The aim of this prospective case series is to descriptively report clinical data with the application of 2OCA as a topical incision closure system in female pelvic surgery. The primary outcomes included: incisional pain, incisional dehiscence, and post-operative bleeding. The secondary outcome included drying times of the adhesive with regard to incision length. Methods: A prospective open-label observational case series study was conducted to evaluate the use of 2OCA in surgical wound closure of the topical skin in adult patients undergoing gynecologic surgical procedures. A total of 50 adult women undergoing gynecologic surgery were enrolled. 2OCA was applied only by surgeons who had undergone product training to the incisions in a standardized, protocol-defined fashion. Drying times for the adhesive and photography were recorded intraoperatively. Post treatment follow-up was conducted with queries of pain level, incisional dehiscence, and incisional bleeding immediately post-operatively, 48 hours, 5 - 10 days and 14 days post-treatment. Adverse events were documented. Results: 2OCA was applied to a total of 154 incisions from the 50 patients enrolled to the study. The procedures included: 16 laparoscopic total hysterectomies, 4 diagnostic laparoscopies, 2 laparoscopic myomectomies, 2 laparoscopic bilateral or unilateral salpingo-oophorectomies, 5 total robotic-assisted laparoscopic surgeries (2 total hysterectom

关键词： Female Pelvic Surgery Gynecologic Surgery Octyl Cyanoacrylate Surgical Incision Skin Closure

Plausible combinations: An improved method to evaluate the covariate structure of Cormack-Jolly-Seber mark-recapture models

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Open Journal of Ecology 2013年第1期3卷 11-22页

作者： jeffrey F. Bromaghin Trent l. McDonald Steven C. Amstrup Polar Bears International Bozeman USA US Geological Survey Alaska Science Center Anchorage USA Western Ecosystems Technology Inc. Cheyenne USA

Mark-recapture models are extensively used in quantitative population ecology, providing estimates of population vital rates, such as survival, that are difficult to obtain using other methods. Vital rates are commonly modeled as functions of explanatory covariates, adding considerable flexibility to mark-recapture models, but also increasing the subjectivity and complexity of the modeling process. Consequently, model selection and the evaluation of covariate structure remain critical aspects of mark-recapture modeling. The difficulties involved in model selection are compounded in Cormack-Jolly-Seber models because they are composed of separate sub-models for survival and recapture probabilities, which are conceptualized independently even though their parameters are not statistically independent. The construction of models as combinations of sub-models, together with multiple potential covariates, can lead to a large model set. Although desirable, estimation of the parameters of all models may not be feasible. Strategies to search a model space and base inference on a subset of all models exist and enjoy widespread use. However, even though the methods used to search a model space can be expected to influence parameter estimation, the assessment of covariate importance, and therefore the ecological interpretation of the modeling results, the performance of these strategies has received limited investigation. We present a new strategy for searching the space of a candidate set of Cormack-Jolly-Seber models and explore its performance relative to existing strategies using computer simulation. The new strategy provides an improved assessment of the importance of covariates and covariate combinations used to model survival and recapture probabilities, while requiring only a modest increase in the number of models on which inference is based in comparison to existing techniques.

关键词： Capture-Recapture Survival Model Building Model Selection Model Averaging Multi-Model Inference Covariates Covariate Weights CJS Akaike’s Information Criterion AIC AICC

缺血性卒中后应用他汀类药物治疗和坚持国际胆固醇指导方案

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世界核心医学期刊文摘（神经病学分册） 2006年第9期2卷 13-14页

作者： Ovbiagele B. saver J. l. Bang H. 张慧(译) Stroke Center and Department of Neurology University of California at Los Angeles 710 Westwood Plaza Los Angeles CA 90095 United States 不详

Background: National cholesterol guidelines have defined high vascular risk individuals as those who could potentially benefit most from statin therapy. The authors aimed to determine the rate of statin use, its predictors, and the achievement of national guideline target lipid goals among ischemic stroke survivors. Methods: The authors abstracted data from the Vitamin Intervention for Stroke Prevention (VISP) study database from the United States and Canada to incorporate into algorithms for initiating statin therapy according to the National Cholesterol Education Program (NCEP) guidelines for high-risk individuals. The authors applied these algorithms to all study subjects. Univariate as well as multivariate associations for target lipid levels and statin implementation were then evaluated utilizing pertinent demographic, clinical, and laboratory data. Results: Of 2,894 subjects in the analysis dataset, 38%were women; 71%were recruited in the United States and 29%in Canada. Of 769 high-risk subjects, 262 (34%) had a low-density lipoprotein (lDl) level ≥130 mg/dl and 124 of these (47%) were not on statin. Among those high-risk persons on statin treatment, only 42%had an lDl ≤100 mg/dl. Subjects in the overall cohort were more likely to be on a statin if they were treated in the United States or had a history of hypertension or coronary artery disease. Conclusions: Approximately one out of three guideline-eligible high vascular risk ischemic stroke patients in this study had low-density lipoprotein cholesterol concentrations above qualifying levels for pharmacologic therapy, but half of these patients were not taking a statin, and of those receiving statin treatment, less than half were within recommended lipid goals.

关键词：胆固醇教育计划他汀类药物药物治疗缺血性卒中卒中后国际高危个体药物使用情况

Resampling Simulator for the Probability of Detecting Invasive Species in large Populations

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Journal of Software Engineering and Applications 2014年第6期7卷 498-505页

作者： David E. legg jeffrey G. Fidgen Krista l. Ryall Department of Ecosystem Science and Management University of Wyoming Laramie USA Great lakes Forestry Centre Sault Ste. Marie Canada

This paper proposes a resampling simulator that will calculate probabilities of detecting invasive species infesting hosts that occur in large numbers. Different methods were examined to determine the bias of observed cumulative distribution functions (c.d.f.s), generated from prototype resampling simulators. One involved seeing if they matched theoretical c.d.f.s, which were generated using formulae for calculating the probability of the union of many events (union formulae), which are known to be correct. Others involved assessing the bias of observed c.d.f.s, generated from using prototype resampling simulators operating on much larger simulated populations, when computation of theoretical c.d.f.s from the union formulae was not practical. Examples are given for using the proposed resampling simulator for detecting an invasive insect pest within the context of an invasive species management system.

关键词： Resampling Simulator Detection of Invasive Species Invasive Species Management System large Populations

An Update on Abscisic Acid Signaling in Plants and More

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Molecular Plant 2008年第2期1卷 198-217页

作者： Aleksandra Wasilewsk.a Florina Vlad Caroline Sirichandra Yulia Redko Fabien Jammes Christiane Valon Nicolas Frei dit Frey jeffrey leung Institut des Sciences du Vegetal Centre National de la Recherche Scientifique UPR 23551 Avenue de la Terrasse Bat. 23 91190 Gif-sur-Yvette France CNRS UPR9073 Institut de Biologie Physico-Chimique 13 rue Pierre et Marie Curie 75005 Paris France laboratoire Signalisation et Regulation Coordonnee du Metabolisme Carbone et Azote Institut de Biotechnologie des Plantes (UMR8618) Universite Paris-Sud F-91405 Orsay Cedex France

The mode of abscisic acid （ABA） action, and its relations to drought adaptive responses in particular, has been a captivating area of plant hormone research for much over a decade. The hormone triggers stomatal closure to limit water loss through transpiration, as well as mobilizes a battery of genes that presumably serve to protect the cells from the ensuing oxidative damage in prolonged stress. The signaling network orchestrating these various responses is, however, highly complex. This review summarizes several significant advances made within the last few years. The biosynthetic pathway of the hormone is now almost completely elucidated, with the latest identification of the ABA4 gene encoding a neoxanthin synthase, which seems essential for de novo ABA biosynthesis during water stress. This leads to the interesting question on how ABA is then delivered to perception sites. In this respect, regulated transport has attracted renewed focus by the unexpected finding of a shoot-to-root translocation of ABA during drought response, and at the cellular level, by the identification of a B-galactosidase that releases biologically active ABA from inactive ABA-glucose ester. Surprising candidate ABA receptors were also identified in the form of the Flowering Time Control Protein A （FCA） and the Chloroplastic Magnesium Protoporphyrin-IX Chelatase H subunit （CHlH） in chloroplast-nucleus communication, both of which have been shown to bind ABA in vitro. On the other hand, the protein（s） corresponding to the physiologically detectable cell-surface ABA receptor（s） is （are） still not known with certainty. Genetic and physiological studies based on the guard cell have reinforced the central importance of reversible phosphorylation in modulating rapid ABA responses. Sucrose Non-Fermenting Related Kinases （SnRK）, Calcium-Dependent Protein Kinases （CDPK）, Protein Phosphatases （PP） of the 2C and 2A classes figure as prominent regulators in this single-cell model. Identifying their d

关键词： Abscisic Acid Signaling Plants and More

^(68)Gallium-labelled PSMA-PET/CT as a diagnostic and clinical decision-making tool in Asian prostate cancer patients following prostatectomy

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Cancer Biology & Medicine 2019年第1期16卷 157-165页

作者： Janice S.H.Tan Charles X.Y.Goh Yen Sin Koh Youquan li jeffrey K.l.Tuan Eu Tiong Chua Terence W.K.Tan Michael l.C.Wang lui Shiong lee Kae Jack Tay Ravindran Kanesvaran Chee Keong Toh Aaron K.T.Tong Winnie W.C.lam Melvin l.K.Chua Division of Radiation Oncology National Cancer Centre Singapore Department of Nuclear Medicine and Molecular Imaging Singapore General Hospital Radiological Sciences Academic Clinical Programme Duke-NUS Medical School Oncology Academic Clinical Programme Duke-NUS Medical School Department of Urology Singapore General Hospital Department of Surgery Sengkang General Hospital Division of Medical Oncology National Cancer Centre Singapore Division of Medical Sciences National Cancer Centre Singapore

Objective: Prostate cancers(PCa) in Asian individuals are molecularly distinct from those found in their Caucasian *** is no risk stratification tool for Asian men with rapid biochemical recurrence(BCR) following radical prostatectomy(Rad P). This study aims to assess the detection rate of ^(68)Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography(PSMA-PET/CT) for diagnosis of clinical recurrence and as a treatment decision making tool in Asian patients with BCR post-Rad ***: ^(68)Ga PSMA-PET and CT body with/without bone scan [conventional workup(CWU)] were performed in 55 Asian patients with BCR within 36 months post-Rad P. Two blinded reviewers assessed the images. Detection rates of ^(68)Ga PSMAPET/CT were evaluated, and impact on management was reviewed by comparison with ***: Median time to BCR post-Rad P was 8.1 months. Detection rate for ^(68)Ga PSMA-PET/CT was 80%(44/55). A positive scan was significantly associated with increasing prostate-specific antigen(PSA) level [odds ratio(OR) = 1.13(95% CI 1.05–1.30), P =0.017], but not with higher Gleason grade or shorter PSA doubling time. Compared to CWU, ^(68)Ga PSMA-PET/CT detected an additional 106 lesions in 33/44 patients with a positive scan, resulting in a change in management in 25/44(56.8%) patients: 10 to hormonal therapy(HT) and whole pelvis radiotherapy(RT) in addition to bed RT, and 15 to palliative HT ***: In the present report, we demonstrated the diagnostic and treatment decision utility of ^(68)Ga PSMA-PET/CT in Asian men with rapid BCR. Detection of small volume nodal and systemic recurrences at low PSA levels(l) highlights the role of the tool in assigning patients to treatment intensification with HT-RT or palliative HT in polymetastatic disease.

关键词： ^68Ga PSMA PET/CT prostate cancer Asian diagnostic recurrence prostatectomy salvage radiotherapy

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神经精神科问卷知情者版中文译本的信效度

中国心理卫生杂志 2010年第5期24卷 338-342,361页

作者：马万欣王华丽 jeffrey l.Cummings 于欣北京大学精神卫生研究所卫生部精神卫生学重点实验室(北京大学)北京100191 北京市朝阳区第三医院北京100121 美国加州大学洛杉矶分校美国加利福尼亚州90095

目的:评价神经精神科问卷知情者版(Neuropsychiatric Inventory-Questionnaire,NPI-Q)中文译本的信度与效度。方法:从北京大学精神卫生研究所记忆中心的病例库中,选取51例符合NINCDS-ADR-DA诊断标准的阿尔茨海默病(probable AD)患者,接... 详细信息

目的:评价神经精神科问卷知情者版(Neuropsychiatric Inventory-Questionnaire,NPI-Q)中文译本的信度与效度。方法:从北京大学精神卫生研究所记忆中心的病例库中,选取51例符合NINCDS-ADR-DA诊断标准的阿尔茨海默病(probable AD)患者,接受简明智能精神状况检查(Mini-mental Status Exami-nation,MMSE)、日常生活活动量表(Activities of Daily living,ADl)、阿尔茨海默病评定量表(Alzheimer'sdisease Assessment Scale-Cognitiveportion,ADAS-cog)、神经精神科问卷(Neuropsychiatric Inventory,NPI)评定,并由其知情者进行NPI-Q评分。其中16例在临床干预3个月后进行重测。结果:(1)NPI-Q克朗巴赫系数α=0.851,Guttman分半系数为0.825;NPI-Q总分重测信度为ICC=0.860(P0.05)。(2)NPI-Q各条目评分之间的相关系数为0.01～0.97,均与总分呈正相关(r=0.33～0.87,Pl、ADAS-cog、NPI总分、NPI苦恼程度评分均相关(r=0.47～0.82,均Pl、ADAS-cog、NPI总分、NPI苦恼程度相关(r=0.29～0.68,P<0.05)。因子分析提示NPI-Q含有精神病性、情感损害和额叶功能3个因子,总贡献率达62.23%。结论:神经精神科问卷知情者版中文译本具有较好的信度和效度,值得推广应用。

关键词：神经精神科问卷知情者版(NPI—Q) 阿尔茨海默病信度效度

Impacts of climate change on hydrology,water quality and crop productivity in the Ohio-Tennessee River Basin

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International Journal of Agricultural and Biological Engineering 2015年第3期8卷 36-53页

作者： Yiannis Panagopoulos Philip W.Gassman Raymond W.Arritt Daryl E.Herzmann Todd D.Campbell Adriana Valcu Manoj K.Jha Catherine l.Kling Raghavan Srinivasan Michael White jeffrey G.Arnold Center for Agricultural and Rural Development(CARD) Iowa State UniversityAmesIA 50011-1070USA Department of Agronomy 2104 Agronomy HallIowa State UniversityAmes IA 50011-1010USA Department of Civil Architectural and Environmental Engineering456 McNair HallNorth Carolina A&T State UniversityGreensboroNC 27411USA Departments of Ecosystem Sciences and Management and Biological and Agricultural Engineering 1500 Research ParkwaySuite B223220 TAMUTexas A&M UniversityCollege StationTX 77843-2120USA Grassland Soil and Water Research laboratory U.S.Department of Agriculture-Agricultural Research Service808 East Blackland RoadTempleTX 76502USA

Nonpoint source pollution from agriculture is the main source of nitrogen and phosphorus in the stream systems of the Corn Belt region in the Midwestern *** eastern part of this region is comprised of the Ohio-Tennessee River Basin(OTRB),which is considered a key contributing area for water pollution and the Northern Gulf of Mexico hypoxic zone.A point of crucial importance in this basin is therefore how intensive corn-based cropping systems for food and fuel production can be sustainable and coexist with a healthy water environment,not only under existing climate but also under climate change conditions in the *** address this issue,a OTRB integrated modeling system has been built with a greatly refined 12-digit subbasin structure based on the Soil and Water Assessment Tool(SWAT)water quality model,which is capable of estimating landscape and in-stream water and pollutant yields in response to a wide array of alternative cropping and/or management strategies and climatic *** effects of three agricultural management scenarios on crop production and pollutant loads exported from the crop land of the OTRB to streams and rivers were evaluated:(1)expansion of continuous corn across the entire basin,(2)adoption of no-till on all corn and soybean fields in the region,(3)implementation of a winter cover crop within the baseline *** effects of each management scenario were evaluated both for current climate and projected mid-century(2046-2065)climates from seven global circulation models(GCMs).In both present and future climates each management scenario resulted in reduced erosion and nutrient loadings to surface water bodies compared to the baseline agricultural management,with cover crops causing the highest water pollution *** and soybean yields in the region were negligibly influenced from the agricultural management *** the other hand,both water quality and crop yield numbers under climate change deviated considerably f

关键词： agricultural management scenarios corn-based systems global circulation models hydrology water quality crop yields SWAT Ohio-Tennessee River Basin