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Clinician’s perspectives in using head impulse-nystagmus- test of skew (HINTS) for acute vestibular syndrome: UK experience

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Stroke & Vascular Neurology 2022年第2期7卷 172-175页

作者： Charlotte l Warner lisa Bunn Nehzat Koohi Gunnar Schmidtmann jennifer Freeman Diego Kaski School of Health Professions University of PlymouthPlymouthUK Department of Clinical and Movement Neurosciences University College LondonLondonUK The Ear Institute University College LondonLondonUK Neuro-otology Department University College London HospitalsLondonUK

Background Acute vestibular syndrome(AVS)features continuous dizziness and may result from a benign inner ear disorder or *** head impulse-nystagmus-test of skew(HINTS)bedside assessment is more sensitive than brain MRI in identifying stroke as the cause of AVS within the first 24 ***’perspectives of the test in UK secondary care remains ***,we explore front-line clinicians’perspectives of use of the HINTS for the diagnosis of *** Clinicians from two large UK hospitals who assess AVS patients completed a short online survey,newly designed with closed and open *** Almost half of 73 total responders reported limited(n=33),or no experience(n=19),reflected in low rates of use of HINTS(n=31).While recognising the potential utility of HINTS,many reported concerns about subjectivity,need for specialist skills and poor patient *** clinicians reported high levels of confidence in performing HINTS,with 98%identifying training needs.A lack of formalised training was associated with onward specialist referrals and neuroimaging(p=0.044).Conclusions Although the low sample size in this study limits the generalisability of findings to wider sites,our preliminary data identified barriers to the application of the HINTS in AVS patients and training needs to improve rapid,cost-effective and accurate clinical diagnosis of stroke presenting with vertigo.

关键词： AVS diagnosis formal

Comparison of intraocular pressure readings with Perkins,Tonopen,iCare 200,and iCare Home to manometry in cadaveric eyes

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International Journal of Ophthalmology(English edition) 2022年第12期15卷 2022-2027页

作者： Monica K Ertel leonard K Seibold jennifer l Patnaik Malik Y Kahook Department of Ophthalmology University of ColoradoUC Health Sue Anschutz-Rodgers Eye CenterAuroraColorado 80045USA

AIM:To compare intraocular pressure(IOP)readings obtained with Perkins tonometry,i Care Home,i Care 200,and Tonopen to IOP readings obtained with the manometer of a perfusion system to assess the accuracy and reproducibility of each method of tonometry at set ***:The IOP of human cadaveric eyes(n=2)was measured using a manometer inserted into the eye through the optic *** measurements were obtained using a Perkins tonometer,i Care Home,i Care 200,and *** measurements were compared to set point IOP measurements of a manometer to determine accuracy and reproducibility of each ***:Mean IOP readings obtained with the Perkins tonometer compared to manometer readings demonstrated a difference of-1.0±5.0 mm Hg(P=0.45),indicating a lower reading on average than manometery although not *** IOP difference between iCare 200 and manometer was 5.3±2.2 mm Hg(Ple the Tonopen measurements demonstrated a 4.0 mm Hg standard *** comparison,iCare 200 and iCare Home demonstrated 2.2 and 2.4 mm Hg standard deviation,***:Applanation tonometry produces more accurate IOP readings than rebound tonometry or Tonopen,however it demonstrates greater variability than the other forms of *** tonometry is more reproducible but tends to over-estimate IOP.

关键词： intraocular pressure ocular tonometry manometry

Immunotherapy for recurrent hepatocellular carcinoma

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World Journal of Gastroenterology 2023年第15期29卷 2261-2271页

作者： Ahan Bhatt jennifer Wu Division of Hematology and Oncology Perlmutter Cancer Center of NYU Langone HealthNYU School of MedicineNew YorkNY 10016United States

Hepatocellular carcinoma(HCC)is presented frequently in late stages that are not amenable for curative *** for patients who can undergo resection for curative treatment of HCC,up to 50%*** patients who were not exposed to systemic therapy prior to recurrence,recurrence frequently cannot be subjected to curative therapy or local *** patients have several options of immunotherapy(IO).This includes programmed cell death protein 1(PD-1)and cytotoxic T-lymphocyte associated protein 4 treatment,combination of PD-1 and vascular endothelial growth factor inhibitor or single agent PD-1 therapy when all other options are deemed *** are also investigational therapies in this area that explore either PD-1 and tyrosine kinase inhibitors or a novel agent in addition to PD-1 with vascular endothelial growth factor *** minireview explored IO options for patients with recurrent HCC who were not exposed to systemic therapy at the initial *** also discussed potential IO options for patients with recurrent HCC who were exposed to first-line therapy with curative intent at diagnosis.

关键词： liver neoplasms Immune checkpoint blockade Combination drug therapy PD-1-PD-l1 blockade CTlA-4 inhibitor

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

Increased CD4/CD8 lymphocyte ratio predicts favourable neoadjuvant treatment response in gastric cancer:A prospective pilot study

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World Journal of Gastrointestinal Oncology 2023年第2期15卷 303-317页

作者： Daniel Skubleny Andrea lin Saurabh Garg Ross Mclean Michael McCall Sunita Ghosh jennifer l Spratlin Daniel Schiller Gina Rayat Department of Surgery University of AlbertaEdmonton T6G 2R3ABCanada Department of Surgery University of AlbertaEdmonton T6G 2R3AlbertaCanada Department of laboratory Medicine and Pathology University of AlbertaEdmonton T6G 2R3AlbertaCanada Department of Oncology University of AlbertaEdmonton T6G 2R3AlbertaCanada Department of Oncology Cross Cancer InstituteUniversity of AlbertaEdmonton T5G 1Z2ABCanada

BACKGROUND Despite optimal neoadjuvant chemotherapy only 40%of gastric cancer tumours achieve complete or partial treatment *** the absence of treatment response,neoadjuvant chemotherapy in gastric cancer contributes to adverse events without additional survival benefit compared to adjuvant treatment or surgery *** strategies and methods are required to optimize the allocation of existing treatment regimens such as FlOT chemotherapy(5-Fluorouracil,leucovorin,Oxaliplatin and Docetaxel).Predictive biomarkers detected using immunohistochemistry(IHC)methods may provide useful data regarding treatment *** To investigate the utility of CD4,CD8,Galectin-3 and E-cadherin in predicting neoadjuvant FlOT chemotherapy tumour response in gastric *** Forty-three adult patients with gastric adenocarcinoma,of which 18 underwent neoadjuvant chemotherapy,were included in a prospective clinical *** biopsies were obtained from gastric cancer and normal adjacent gastric *** in expression of Galectin-3,Ecadherin,CD4^(+)and CD8^(+)molecules between tumours with and without treatment response to neoadjuvant chemotherapy were assessed with *** response was graded by clinical pathologists using the Tumour Regression Score according to the College of American Pathologists *** response was defined as complete or near complete tumour response,whereas partial or poor/no response was defined as *** IHC images were annotated and quantitatively assessed using QuPath *** expression between responsive and incomplete response tumours was assessed using a two-sided Wilcoxon *** expression was also compared between normal and cancer tissue and between 15 paired tumour samples before and after *** performed a preliminary multivariate analysis and power analysis to guide future *** analyses were completed using R *** The ratio betw

关键词： CD4 CD8 Galectin-3 Neoadjuvant chemotherapy Treatment response Gastric cancer

Microbial community coalescence and nitrogen cycling in simulated mortality decomposition hotspots

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Ecological Processes 2023年 608-624页

作者： Sarah W.Keenan Alexandra l.Emmons jennifer M.De Bruyn Department of Geology and Geological Engineering South Dakota School of Mines and Technology Department of Anthropology University of Tennessee Department of Biosystems Engineering and Soil Science University of Tennessee

Background The pulsed introduction of dead plant and animal material into soils represents one of the primary mechanisms for returning organic carbon(C) and nitrogen(N) compounds to biogeochemical cycles. Decomposition of animal carcasses provides a high C and N resource that stimulates indigenous environmental microbial communities and introduces non-indigenous, carcass-derived microbes to the environment. However, the dynamics of the coalesced microbial communities, and the relative contributions of environment-and carcass-derived microbes to C and N cycling are unknown. To test whether environment-derived, carcass-derived, or the combined microbial communities exhibited a greater influence on C and N cycling, we conducted controlled laboratory experiments that combined carcass decomposition fluids and soils to simulate carcass decomposition hotspots. We selectively sterilized the decomposition fluid and/or soil to remove microbial communities and create different combinations of environment-and carcass-derived communities and incubated the treatments under three temperatures(10, 20,and 30 °C).Results Carcass-derived bacteria persisted in soils in our simulated decomposition scenarios, albeit at low abundances. Mixed communities had higher respiration rates at 10 and 30 °C compared to soil or carcass communities alone. Interestingly, at higher temperatures, mixed communities had reduced diversity, but higher respiration,suggesting functional redundancy. Mixed communities treatments also provided evidence that carcass-associated microbes may be contributing to ammonification and denitrification, but that nitrification is still primarily carried out by native soil *** Our work yields insight into the dynamics of microbial communities that are coalescing during carcass decomposition, and how they contribute to recycling carcasses in terrestrial ecosystems.

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Mortality in patients with heart failure and suicidal ideation discharged to skilled nursing facilities

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Journal of Geriatric Cardiology 2022年第3期19卷 198-208页

作者： Melanie l Bozzay lan Jiang Andrew R Zullo Melissa R Riester Jacob A lafo Zachary J Kunicki James l Rudolph Caroline Madrigal Rachel Clements Sebhat Erqou Wen-Chih Wu Stephen Correia jennifer M Primack Department of Psychiatry&Human Behavior Alpert Medical School of Brown UniversityBox G-BHProvidenceRhode IslandUnited States VA RR&D Center for Neurorestoration and Neurotechnology Providence VA Medical Center830 Chalkstone BoulevardProvidenceRhode IslandUnited States VA Center of Innovation in long Term Services Providence VA Medical Center830 Chalkstone BoulevardProvidenceRhode IslandUnited States Department of Health Services Policyand PracticeBrown University School of Public HealthBox G-S121-8ProvidenceRhode IslandUnited States Department of Medicine Alpert Medical School of Brown UniversityBox G-BHProvidenceRhode IslandUnited States

Heart failure(HF)is a leading cause of morbidity and mortality in the United States.[1]A chronically,disabling and debilitating condition,HF often results in hospital admission and subsequent readmission.[2]After hos-pitalization,nearly 25%of older adults with HF are discharged to skilled nursing facilities(SNFs)for re-habilitation due to difficulties with functioning in-dependently.[3]Critically,patients with HF dis-charged to SNFs also show significantly higher rates of mortality.[2]Identifying factors that predict mortality among this important patient population,especially factors that could be addressed in the hospital setting,is an important step toward im-proving survivability among these patients.

关键词： patients mortality nursing

Frailty is independently associated with increased hospitalisation days in patients on the liver transplant waitlist

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World Journal of Gastroenterology 2017年第5期23卷 899-905页

作者： Marie Sinclair Eduard Poltavskiy jennifer l Dodge jennifer C lai Gastroenterology and Hepatology University of CaliforniaSan FranciscoCa 94143United States

AIM To investigate the impact of physical frailty on risk of hospitalisation in cirrhotic patients on the liver transplant *** Cirrhotics listed for liver transplantation at a single centre underwent frailty assessments using the Fried Frailty Index, consisting of grip strength, gait speed, exhaustion, weight loss, and physical activity. Clinical and biochemical data including MElD score as collected at the time of assessment. The primary outcome was number of hospitalised days per year; secondary outcomes included incidence of infection. Univariable and multivariable analysis was performed using negative binomial regression to associate baseline parameters including frailty with clinical outcomes and estimated incidence rate ratios(IRR). RESUlTS Of 587 cirrhotics, 64% were male, median age(interquartile range) was 60(53-64) years and MElD score was 15(12-18). Median Fried Frailty Index was 2(1-3); 31.6% were classified as frail(fried frailty ≥ 3). During 12 mo of follow-up, 43% required at least 1hospitalisation; 38% of which involved major infection.107/184(58%) frail and 142/399(36%) non-frail patients were hospitalised at least once(P le analysis, Fried Frailty Index was associated with total hospitalisation days per year(IRR = 1.51,95%CI: 1.28-1.77; P ≤ 0.001), which remained significant on multivariable analysis after adjustment for MElD, albumin, and gender(IRR for frailty of 1.21,95%CI: 1.02-1.44; P = 0.03). Incidence of infection was not influenced by *** In cirrhotics on the liver transplant waitlist, physical frailty is a significant predictor of hospitalisation and total hospitalised days per year, independent of liver disease severity.

关键词： Hospitalisation 感染肝硬化脆弱移植

Advancements and challenges in treating advanced gastric cancer in the West

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World Journal of Gastrointestinal Oncology 2019年第9期11卷 652-664页

作者： jennifer l leiting Travis E Grotz Division of Hepatobiliary and Pancreas Surgery Mayo Clinic

Gastric cancer is a leading cause of cancer incidence and death *** with advanced gastric cancer benefit from a multi-modality treatment *** oncologic resection with negative margins and complete lymphadenectomy plays a crucial role in long-term survival for patients with resectable *** utilization of minimally invasive techniques for gastric cancer has been slowly increasing and is proving to be both technically and oncologically *** chemotherapy is the current standard of care for advanced gastric cancer.A variety of chemotherapy regimens have been used with the combination of docetaxel,oxaliplatin,5-fluorouracil,and leucovorin being the current recommendation given its superior ability to induce a complete pathologic response and prolong *** use of radiation has been more controversial with its optimal place in the treatment sequence being *** are current ongoing studies assessing the impact of radiation as an adjunct or in place of *** treatments(e.g.,trastuzumab for human epidermal growth factor receptor 2 positive tumors and pembrolizumab for programmed death-ligand 1 positive tumors)are showing promise and are part of a continued emphasis on individualized *** chemotherapy may also play a role in preventing peritoneal recurrences for patients with high risk *** treatment of patients with advanced gastric cancer in the West continues to advance and improve with a better understanding of optimal treatment sequences and the utilization of personalized treatment regimens.

关键词： Gastric cancer D2 lymphadenectomy Minimally invasive surgery Neoadjuvant chemotherapy Chemoradiation Targeted treatments