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Predictors of double balloon endoscopy outcomes in the evaluation of gastrointestinal bleeding

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World Journal of Gastrointestinal Endoscopy 2014年第6期6卷 248-253页

作者： Hisham Hussan Nicholas R Crews Caroline M Geremakis Soubhi Bahna jennifer l labundy Christine Hachem Section of Intestinal Neoplasia and Hereditary Polyposis(INHP) Department of GastroenterologyHepatology and NutritionThe Ohio State University Medical Center Division of Gastroenterology and Hepatology Saint Louis University School of Medicine School of Medicine Saint Louis University School of Medicine Center for Outcomes Research Saint Louis University Department of Internal Medicine Saint Louis University School of Medicine

AIM:To identify patients' characteristics associated with double balloon endoscopy(DBE)outcomes in investigation of obscure gastrointestinal bleeding(OGIB).METHODS:Retrospective study performed at an academic tertiary referral *** endpoints were clinical factors associated with no diagnostic yield or non-therapeutic intervention of DBE performed for OGIB ***:We included fifty-five DBE between August 2010 and April *** mean age of the sample was 67 with 32 males(58.2%).Twenty-four DBE had no diagnostic yield and 30 DBE did not require ***-diagnostic yield was associated with performing two or more DBE studies in one day [odds ratio(OR):13.72,P=0.008],absence of blood transfusions within a year of the DBE(OR:7.16,P=0.03)and absence of ulcers or arteriovenous malformations(AVMs)on prior esophagogastroduodenoscopy(EGD)or colonoscopy(OR:19.30,P=0.033).Non-therapeutic DBE was associated with performing two or more DBE per day(OR:18.579,P=0.007),gastrointestinal bleeding episode within a week of the DBE(OR:11.48,P=0.003),fewer blood transfusion requirements prior to DBE(OR:4.55,P=0.036)and absence of ulcers or AVMs on prior EGD or colonoscopy(OR:8.47,P=0.027).CONClUSION:Predictors of DBE yield and therapeutic intervention on DBE include blood transfusion requirements,previous endoscopic findings and possibly endoscopist fatigue.

关键词： Double balloon endoscopy Enteroscopy Obscure gastrointestinal bleeding Small bowel Anemia Arteriovenous malformations Arteriovenous malformations

Pancreatic surgery and tertiary pancreatitis services warrant provision for support from a specialist diabetes team

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World Journal of Diabetes 2024年第4期15卷 598-605页

作者： Vasileios K Mavroeidis jennifer Knapton Francesca Saffioti Daniel l Morganstein Department of HPB Surgery Bristol Royal InfirmaryUniversity Hospitals Bristol and Weston NHS Foundation TrustBristol BS28HWUnited Kingdom Department of Gastrointestinal Surgery Southmead HospitalNorth Bristol NHS TrustBristol BS105NBUnited Kingdom Department of Academic Surgery Royal Marsden NHS Foundation TrustLondon SW36JJUnited Kingdom Department of Gastroenterology and Hepatology Oxford University Hospitals NHS Foundation TrustOxford OX39DUUnited Kingdom UCl Institute for liver and Digestive Health University College LondonLondon NW32PFUnited Kingdom Department of Endocrinology Chelsea and Westminster Hospital NHS Foundation TrustLondon SW109NHUnited Kingdom Department of Gastrointestinal Unit Royal Marsden NHS Foundation TrustLondon SW36JJUnited Kingdom

Pancreatic surgery units undertake several complex operations,albeit with consi-derable morbidity and mortality,as is the case for the management of complicated acute pancreatitis or chronic *** centralisation of pancreatic surgery services,with the development of designated large-volume centres,has contribu-ted to significantly improved *** this editorial,we discuss the complex associations between diabetes mellitus(DM)and pancreatic/periampullary disease in the context of pancreatic surgery and overall management of complex pancreatitis,highlighting the consequential needs and the indispensable role of specialist diabetes teams in support of tertiary pancreatic *** 3c pan-creatogenic DM,refers to DM developing in the setting of exocrine pancreatic disease,and its identification and management can be challenging,while the glycaemic control of such patients may affect their course of treatment and *** preoperative diabetes assessment is warranted to aid identification of patients who are likely to need commencement or escalation of glucose lowering therapy in the postoperative *** incidence of new onset diabetes after pancreatic resection is widely variable in the literature,and depends on the type and extent of pancreatic resection,as is the case with pancreatic parenchymal loss in the context of severe *** involvement of a specialist diabetes team is essential to ensure a holistic *** the current era,large volume pancreatic surgery services commonly abide by the principles of enhanced recovery after surgery,with inclusion of provisions for optimisation of the perioperative glycaemic control,to improve *** various guidelines are available to aid perioperative management of DM,auditing and quality improvement platforms have highlighted deficiencies in the perioperative management of diabetic patients and areas of required *** need for perioperative support of diabetic

关键词： Pancreatectomy Pancreatoduodenectomy Whipple’s Pancreatitis Diabetes specialist Type 3c pancreatogenic diabetes mellitus

Implementation of an international medical student pen-pal club:survey outcomes of perceptions in cultural competency and global health

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Global Health Journal 2024年第1期8卷 11-15页

作者： Max J.Goodman jennifer livschitz Ji Won Kim Megan l.Schultz Medical College of Wisconsin MilwaukeeWI 53226USA Department of Pediatrics Division of Emergency MedicineMedical College of WisconsinMilwaukeeWI53226USA

Background:Pen-pal clubs(PPC)are used worldwide for students to learn about different cultures and other skillsets without the need for *** medical students are interested in global health opportunities abroad but costs,scheduling,and other barriers allow few to participate in such *** is important that medical students have nuanced global medical perspectives and can contribute to the global medical ***:The purpose of this study is to demonstrate that an international medical student PPC improves medical students'perspectives of cultural competency and global health ***:In 2021,a novel medical student PPC was established that began between an American and Japanese medical *** a shareholders meeting,it was decided that the number of medical schools involved globally be expanded through previous institutional affiliations and online *** total,the club connected 50 American medical students and 52 medical students from 17 high-and middle-income *** primary form of communication was online;pen-pals were encouraged to communicate monthly using provided topics,although frequency and way of communication was their *** February 2022,American PPC members were emailed a qualitative survey to assess the PPC's ***:The survey was completed by 42%of American PPC members,95%of which were 22-26 *** were preclinical medical students,60%whom were female and the majority either white(47%)or Asian(43%).Overall,the PPC positively influenced American medical students'perception of global medicine,medical education,and their cultural competency after joining the PPC compared to prior(P=0.004).Conclusion:PPCs encourage medical students to think from a global perspective and foster open-mindedness within varying social and cultural *** a global communication platform for students during medical school education may be an additional way to train aspiring global l

关键词： Pen-pals Medical student Global health Cultural competency

Are there sex-based disparities in cataract surgery?

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International Journal of Ophthalmology(English edition) 2024年第1期17卷 137-143页

作者： Matthew D.Geiger Anne M.lynch Alan G.Palestine Nathan C.Grove Karen l.Christopher Richard S.Davidson Michael J.Taravella Naresh Mandava jennifer l.Patnaik Department of Ophthalmology University of Colorado School of MedicineAuroraCO 80045USA

AIM:To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract ***:This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado School of *** collected included the patient’s health history,ocular comorbidities,operative and post-operative complications,and the post-operative best corrected visual acuity(BCVA).The data were analyzed using univariate and multivariable logistic regression with generalized estimating equations to account for the correlation of some patients having two eyes included in the ***:A total of 11977 eyes from 7253 patients were included in the *** comorbidities differed by sex,with males having significantly higher percentages of traumatic cataracts(males 0.7%vs females 0.1%),prior ocular surgery(6.7%vs 5.5%),and mature cataracts(2.8%vs 1.9%).Conversely,females had significantly higher rates of pseudoexfoliation(2.0%vs 3.2%).In unadjusted analysis,males had higher rates of posterior capsular rupture(0.8%vs 0.4%)and vitreous loss(1.0%vs 0.6%),but this difference was not significant after adjustment for *** had a significantly increased risk of post-operative retinal detachment,but in multivariable analysis this was no longer *** were significantly less likely to undergo post-operative neodymium-doped yttrium aluminum garnet(Nd:YAG)laser capsulotomy for posterior capsule opacification(OR=0.8,95%CI=0.7-0.9,P=0.0005).The BCVA was slightly worse for males pre-operatively;but post-operatively,both sexes exhibited similar visual acuity of Snellen equivalent 20/***:The study finds that in a cohort of patients presenting for cataract surgery,sex differences exist in pre-operative comorbidities and surgical characteristics that contribute to higher rates of some complications for ***,observed surgical complicatio

关键词： cataract surgery sex-based disparity phacoemulsification outcomes

CSPP1 stabilizes microtubules by capping both plus and minus ends

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Journal of Molecular Cell Biology 2024年第2期16卷 36-46页

作者： Zhikai Wang Wenwen Wang Shuaiyu liu Fengrui Yang Xu liu Shasha Hua lĳuan Zhu Aoqing Xu Donald lHill Dongmei Wang Kai Jiang jennifer lippincott-Schwartz Xing liu Xuebiao Yao MOE Key laboratory for Membraneless Organelles and Cellular Dynamics Center for Advanced Interdisciplinary Science and Biomedicine of IHMUniversity of Science and Technology of China School of Life SciencesHefei 230027China Anhui Key laboratory for Cellular Dynamics and Chemical Biology Hefei National Research Center for Interdisciplinary Sciences at the MicroscaleHefei 230027China Frontier Science Center for Immunology and Metabolism Medical Research InstituteWuhan UniversityWuhan 430071China Comprehensive Cancer Center University of AlabamaBirminghamAL 35233USA Janelia Research Campus Howard Hughes Medical InstituteAshburnVA 20147USA

Although the dynamic instability of microtubules(MTs)is fundamental to many cellular functions,quiescent MTs with unattached free distal ends are commonly present and play important roles in various events to power cellular ***,how these free MT tips are stabilized remains poorly ***,we report that centrosome and spindle pole protein 1(CSPP1)caps and stabilizes both plus and minus ends of static ***-time imaging of laser-ablated MTs in live cells showed deposition of CSPP1 at the newly generated MT ends,whose dynamic instability was concomitantly ***,MT ends in CSPP1-overexpressing cells were hyper-stabilized,while those in CSPP1-depleted cells were much more *** CSPP1-elicited stabilization of MTs was demonstrated to be achieved by suppressing intrinsic MT catastrophe and restricting ***,CSPP1-bound MTs were resistant to mitotic centromere-associated kinesin-mediated *** findings delineate a previously uncharacterized CSPP1 activity that integrates MT end capping to orchestrate quiescent MTs.

关键词： CSPP1 microtubule plus end minus end capping

How completely are randomized controlled trials of non-pharmacological interventions following concussion reported? A systematic review

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Journal of Sport and Health Science 2024年第4期13卷 537-547页

作者： Jacqueline Josee van Ierssel Olivia Galea Kirsten Holte Caroline luszawski Elizabeth Jenkins jennifer O’Neil Carolyn A Emery Rebekah Mannix Kathryn Schneider Keith Owen Yeates Roger Zemek Children’s Hospital of Eastern Ontario Research Institute OttawaON K1H 8L1Canada The Centre for Health Activity and Rehabilitation ResearchUniversity of OtagoDunedin 9016New Zealand Sport Injury Prevention Research Centre Faculty of KinesiologyUniversity of CalgaryCalgaryAB T2N 1N4Canada Alberta Children’s Hospital Research Institute University of Calgary CalgaryAB T2N 1N4Canada Hotchkiss Brain Institute University of CalgaryCalgaryAB T2N 4N1Canada Department of Psychology University of CalgaryCalgaryAB T2N 1N4Canada g Faculty of MedicineUniversity of OttawaOttawaON K1H 8M5Canada School of Rehabilitation Sciences University of OttawaOttawaON K1H 8M5Canada Bruyere Research Institute OttawaON K1N 5C8Canada Departments of Pediatrics and Emergency Medicine Harvard Medical SchoolBostonMA 02115USA Departments of Pediatrics and Emergency Medicine University of OttawaOttawaON K1H 8M5Canada

Purpose:The study aimed to examine the reporting completeness of randomized controlled trials(RCTs)of non-pharmacological interventions following ***:We searched MEDlINE,Embase,PsycInfo,CINAHl,and Web of Science up to May *** reviewers independently screened studies and assessed reporting completeness using the Template for Intervention Description and Replication(TIDieR),Consensus on Exercise Reporting Template(CERT),and international Consensus on Therapeutic Exercise aNd Training(i-CONTENT)*** information was sought my study authors where reporting was *** of bias(ROB)was assessed with the Cochrane ROB-2 *** examining non-pharmacological interventions following ***:We included 89 RCTs(n=53 high ROB)examining 11 different interventions for concussion:sub-symptom threshold aerobic exercise,cervicovestibular therapy,physical/cognitive rest,vision therapy,education,psychotherapy,hyperbaric oxygen therapy,transcranial magnetic stimulation,blue light therapy,osteopathic manipulation,and head/neck *** scores were:TIDieR 9/12(75%;interquartile range(IQR)=5;range:5-12),CERT 17/19(89%;IQR=2;range:10-19),and i-CONTENT 6/7(86%;IQR=1;range:5-7).Percentage of studies completely reporting all items was TIDieR 35%(31/89),CERT 24%(5/21),and i-CONTENT 10%(2/21).Studies were more completely reported after publication of TIDieR(t_(87)=2.08;p=0.04)and CERT(t_(19)=2.72;p=0.01).Reporting completeness was not strongly associated with journal impact factor(TIDieR:rs=0.27;p=0.01;CERT:r_(s)=-0.44;p=0.06;i-CONTENT:r_(s)=-0.17;p=0.48)or ROB(TIDieR:rs=0.11;p=0.31;CERT:rs=0.04;p=0.86;i-CONTENT:rs=0.12;p=0.60).Conclusion:RCTs of non-pharmacological interventions following concussion demonstrate moderate to good reporting completeness,but are often missing key components,particularly modifications,motivational strategies,and qualified *** completeness improved after TIDieR and CERT publication,but p

关键词： Concussion Intervention Randomized controlled trial Systematic review

A rat model of multicompartmental traumatic injury and hemorrhagic shock induces bone marrow dysfunction and profound anemia

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Animal Models and Experimental Medicine 2024年第3期7卷 367-376页

作者： lauren S.Kelly jennifer A.Munley Erick E.Pons Kolenkode B.Kannan Elizabeth M.Whitley letitia E.Bible Philip A.Efron Alicia M.Mohr Department of Surgery and Sepsis and Critical Illness Research Center University of Florida College of MedicineGainesvilleFloridaUSA Pathogenesis LLCGainesvilleFloridaUSA

Background:Severe trauma is associated with systemic inflammation and organ *** rodent trauma models are the mainstay of postinjury research but have been criticized for not fully replicating severe human *** aim of this study was to create a rat model of multicompartmental injury which recreates profound traumatic ***:Male Sprague-Dawley rats were subjected to unilateral lung contusion and hemorrhagic shock(lCHS),multicompartmental polytrauma(PT)(unilateral lung contusion,hemorrhagic shock,cecectomy,bifemoral pseudofracture),or na?ve ***,plasma toll-l ike receptor 4(TlR4),hemoglobin,spleen to body weight ratio,bone marrow(BM)erythroid progenitor(CFU-GEMM,BFU-E,and CFU-E)growth,plasma granulocyte colony-stimulating factor(G-CSF)and right lung histologic injury were assessed on day 7,with significance defined as p valueslts:Polytrauma resulted in markedly more profound inhibition of weight gain compared to lCHS(p=0.0002)along with elevated plasma TlR4(plower hemoglobin(plarged spleen to body weight ratios(p=0.004).Both lCHS and PT demonstrated suppression of CFU-E and BFU-E growth compared to naive(plasma G-CSF was elevated in PT compared to both na?ve and lCHS(plCHS and PT demonstrated significant histologic right lung injury with poor alveolar wall integrity and interstitial ***:Multicompartmental injury as described here establishes a reproducible model of multicompartmental injury with worsened anemia,splenic tissue enlargement,weight loss,and increased inflammatory activity compared to a less severe *** may serve as a more effective model to recreate profound traumatic injury to replicate the human inflammatory response postinjury.

关键词： anemia i nflammation polytrauma pseudofracture shock

Elucidating regulatory processes of intense physical activity by multi-omics analysis

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Military Medical Research 2024年第4期11卷 479-499页

作者： Ernesto S.Nakayasu Marina A.Gritsenko Young-Mo Kim jennifer E.Kyle Kelly G.Stratton Carrie D.Nicora Nathalie Munoz Kathleen M.Navarro Daniel Claborne Yuqian Gao Karl K.Weitz Vanessa l.Paurus Kent J.Bloodsworth Kelsey A.Allen lisa M.Bramer Fernando Montes Kathleen A.Clark Grant Tietje Justin Teeguarden Kristin E.Burnum-Johnson Biological Sciences Division Pacific Northwest National LaboratoryRichlandWA 99352USA Environmental and Molecular Sciences Division Pacific Northwest National LaboratoryRichlandWA 99352USA Centers for Disease Control and Prevention National Institute for Occupational Safety and HealthWestern States DivisionDenverCO 80204USA Computational Analytics Division Pacific Northwest National LaboratoryRichlandWA 99352USA National Security Directorate Pacific Northwest National LaboratoryRichlandWA 99352USA los Angeles County Fire Department Los AngelesCA 90063USA Centers for Disease Control and Prevention National Institute for Occupational Safety and HealthRespiratory Health DivisionMorgantownWV 26505USA Environmental and Molecular Toxicology Oregon State UniversityCorvallisOR 97331USA

Background:Physiological and biochemical processes across tissues of the body are regulated in response to the high demands of intense physical activity in several occupations,such as firefighting,law enforcement,military,and sports.A better understanding of such processes can ultimately help improve human performance and prevent illnesses in the work ***:To study regulatory processes in intense physical activity simulating real-life conditions,we performed a multi-omics analysis of 3 biofluids(blood plasma,urine,and saliva)collected from 11 wildland firefighters before and after a 45 min,intense exercise *** profiles ***-exercise were compared by Student’s t-test followed by pathway analysis and comparison between the different omics ***:Our multi-omics analysis identified and quantified 3835 proteins,730 lipids and 182 metabolites combining the 3 different types of *** blood plasma analysis revealed signatures of tissue damage and acute repair response accompanied by enhanced carbon metabolism to meet energy *** urine analysis showed a strong,concomitant regulation of 6 out of 8 identified proteins from the renin-angiotensin system supporting increased excretion of catabolites,reabsorption of nutrients and maintenance of fluid *** saliva,we observed a decrease in 3 pro-inflammatory cytokines and an increase in 8 antimicrobial peptides.A systematic literature review identified 6 papers that support an altered susceptibility to respiratory ***:This study shows simultaneous regulatory signatures in biofluids indicative of homeostatic maintenance during intense physical activity with possible effects on increased infection susceptibility,suggesting that caution against respiratory diseases could benefit workers on highly physical demanding jobs.

关键词： Multi-omics analysis Intense exercise Human performance Biofluids Metabolism Immunity

The effect of gas phase polydimethylsiloxane surface treatment of metallic aluminum particles： Surface characterization and flow behavior

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Particuology 2017年第1期15卷 92-101页

作者： Bellamarie ludwia jennifer l. Gray Applied Research laboratory The Pennsylvania State University North Atherton Street State College PA 16801 USA Materials Research Institute The Pennsylvania State University USA

Aluminum particles were exposed to gaseous polydimethylsiloxane （PDMS） to produce a hydropho- bic surface coating for enhanced flow and fluidity. Surface retention of the intact PDMS was confirmed through infrared and X-ray photoelectron spectroscopy. Transmission electron microscopy was used to image cross-sections of the treated particles and energy dispersive spectroscopy element maps demon- strated the presence of a surface layer consisting of silicon and oxygen. Density measurements provided evidence for improvements in the Hausner ratio and Carr index of the PDMS-treated aluminum, indicating a reduction in inter-particulate cohesion through increased bulk density. Stability, compressibility, shear, aeration, and permeability of the particles were assessed by powder rheometer. The compressibility was reduced by approximately 32% following surface treatment, revealing a reduction in void space, while Mohr＇s circle analysis and shear testing determined that the extrapolated cohesion value was reduced by approximately 53% and the flow factor at 6 kPa was doubled. Aeration testing showed that the air velocity required to obtain a fluidized bed was on the order of 0.35 mm/s for the treated powder, whereas the raw powder could not be uniformly fluidized. PDMS may be a viable option for the large-scale treatment of aluminum powder for flow applications.

关键词： Aluminum powder Polydimethylsiloxane X-ray photoelectron spectroscopy Diffuse reflectance infrared Fourier transform spectroscopy Flowability FT4 powder rheometer