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Impact of stopping smoking on metabolic parameters in diabetes mellitus:A scoping review

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World Journal of Diabetes 2022年第6期13卷 422-433页

作者： Magdalena Walicka Cristina Russo Michael Baxter isaac john Grazia Caci Riccardo Polosa Department of Human Epigenetics Mossakowski Medical Research InstitutePolish Academy of SciencesWarsaw 02-106Poland Department of Internal Diseases Endocrinology and DiabetologyCentral Clinical Hospital of the Ministry of Interior and Administration in WarsawWarsaw 02-507Poland Department of Clinical and Experimental Medicine University of CataniaCatania 95123Italy Ashford and Saint Peter's Hospitals NHS Foundation Trust Chertsey KT160PZUnited Kingdom Department of Clinical and Experimental Medicine University of MessinaMessina 98124Italy Center of Excellence for The Acceleration of HArm Reduction(CoEHAR) University of CataniaCataia 95123Italy Centre for The Prevention and Treatment of Tobacco Addiction(CPCT) Teaching Hospital"Policlinico-V.Emanuele"Catania 95123Italy ECLAT Srl Spin-off of the University of CataniaCatania 95123Italy

The purpose of this scoping review is to create a single narrative that describes the impact of smoking cessation on metabolic parameters in people with *** is generally well accepted that smoking enhances the harmful effects of elevated blood glucose levels,accelerating the vascular damage seen in patients with *** cessation has clear benefits in terms of reducing cardiovascular morbidity and ***,there is less evidence for the impact of smoking cessation on other diabetes-related *** in people with diabetes have shown improvement as well as temporary deterioration in glycemic control after ceasing *** a few studies have described the effect of quitting smoking on insulin resistance and lipid parameters,however,their results have been *** this situation,healthcare professionals should not assume that cessation of smoking will improve metabolic parameters in patients with *** seems they should, first of all, emphasize the prevention of weight gain that may be associatedwith quitting smoking. The lack of data regarding the metabolic effects of smoking and smokingcessation in diabetes is very disappointing and this area needs to be addressed.

关键词： Smoking Smoking cessation Diabetes Insulin resistance Glucose Lipids

Incidental gallbladder cancer diagnosis confers survival advantage irrespective of tumour stage and characteristics

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World Journal of Gastroenterology 2022年第18期28卷 1996-2007页

作者： Moath Alarabiyat Syed Soulat Raza john isaac Darius Mirza Ravi Marudanayagam Keith Roberts Manuel Abradelo David C Bartlett Bobby V Dasari Robert P Sutcliffe Nikolaos A Chatzizacharias HPB and Liver Transplant Unit Queen Elizabeth HospitalBirmingham B152GWUnited Kingdom Department of HPB and Liver Transplantation Queen Elizabeth HospitalUniversity Hospitals BirminghamBirmingham B152THUnited Kingdom

BACKGROUND Incidental gallbladder cancer(IGBC)represents 50%-60%of gallbladder cancer *** are conflicting on the role of IGBC diagnosis in oncological *** studies suggest that IGBC diagnosis does not affect outcomes,while others that overall survival(OS)is longer in these cases compared to non-incidental diagnosis(NIGBC).Furthermore,some studies reported early tumour stages and histopathologic characteristics as possible confounders,while others *** To investigate the role of IGBC diagnosis on patients’overall survival,especially after surgical treatment with curative *** Retrospective analysis of all patient referrals with gallbladder cancer between 2008 and 2020 in a tertiary hepatobiliary *** comparison of patient and tumour characteristics between IGBC and NIGBC subgroups was *** analysis for the whole cohort,surgical and non-surgical subgroups was done with the Kaplan-Meier method and the use of log rank *** analysis was performed with univariable and multivariable Cox regression *** The cohort included 261 patients with gallbladder cancer.65%of cases had NIGBC and 35%had IGBC.A total of 90 patients received surgical treatment(66%of IGBC cases and 19%of NIGBC cases).NIGBC patients had more advanced T stage and required more extensive resections than IGBC *** was longer in patients with IGBC in the whole cohort(29 vs 4 mo,P<0.001),as well as in the non-surgical(14 vs 2 mo,P<0.001)and surgical subgroups(29 vs 16.5 mo,P=0.001).Disease free survival(DFS)after surgery was longer in patients with IGBC(21.5 mo vs 8.5 mo,P=0.007).N stage and resection margin status were identified as independent predictors of OS and *** diagnosis was identified as an independent predictor of *** IGBC diagnosis may confer a survival advantage independently of the pathological stage and tumour *** studies are required to further investigate this,including detailed

关键词： Gallbladder cancer Incidental gallbladder cancer Non-incidental gallbladder cancer Gallbladder cancer survival

Para-aortic lymph node involvement should not be a contraindication to resection of pancreatic ductal adenocarcinoma

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World Journal of Gastrointestinal Surgery 2022年第5期14卷 429-441页

作者： Rupaly Pande Shafiq Chughtai Manish Ahuja Rachel Brown David C Bartlett Bobby V Dasari Ravi Marudanayagam Darius Mirza Keith Roberts john isaac Robert P Sutcliffe Nikolaos A Chatzizacharias Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery University Hospitals Birmingham NHS Foundation TrustBirmingham B152GWUnited Kingdom Department of Pathology University Hospitals Birmingham NHS Foundation TrustBirmingham B152GWUnited Kingdom

BACKGROUND Para-aortic lymph nodes(PALN)are found in the aortocaval groove and they are staged as metastatic disease if involved by pancreatic ductal adenocarcinoma(PDAC).The data in the literature is conflicting with some studies having associated PALN involvement with poor prognosis,while others not sharing the same *** resection is not included in the standard lymphadenectomy during pancreatic resections as per the International Study Group for Pancreatic Surgery and there is no consensus on the management of these *** To investigate the prognostic significance of PALN metastases on the oncological outcomes after resection for *** This is a retrospective cohort study of data retrieved from a prospectively maintained database on consecutive patients undergoing pancreatectomies for PDAC where PALN was sampled between 2011 and *** comparison of the data between PALN+and PALN-subgroups,survival analysis with the Kaplan-Meier method and risk analysis with univariable and multivariable time to event Cox regression analysis were performed,specifically assessing oncological outcomes such as median overall survival(OS)and disease-free survival(DFS).RESULTS 81 cases had PALN sampling and 17(21%)were *** N stage was significantly different between PALN+and PALN-patients(P=0.005),while no difference was observed in any of the other *** imaging diagnosed PALN positivity in one *** and DFS were comparable between PALN+and PALN-patients with lymph node positive disease(OS:13.2 mo vs 18.8 mo,P=0.161;DFS:13 mo vs 16.4 mo,P=0.179).No difference in OS or DFS was identified between PALN positive and negative patients when they received chemotherapy either in the neoadjuvant or in the adjuvant setting(OS:23.4 mo vs 20.6 mo,P=0.192;DFS:23.9 mo vs 20.5 mo,P=0.718).On the contrary,when patients did not receive chemotherapy,PALN disease had substantially shorter OS(5.5 mo vs 14.2 mo;P=0.015)and DFS(4.4 mo

关键词： Para-aortic lymph node Pancreatectomy Survival Pancreatic adenocarcinoma Chemotherapy Lymph node sampling

Prognostic factors and survival after surgical resection of pancreatic neuroendocrine tumor with validation of established and modified staging systems

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Hepatobiliary & Pancreatic Diseases International 2018年第2期17卷 169-175页

作者： Nikolaos Benetatos James Hodson Ravi Marudanayagam Robert P Sutcliffe john R isaac john Ayuk Tahir Shah Keith J Roberts The HPB Unit Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Institute of Translational Medicine Queen Elizabeth Hospital Birmingham University Hospitals Birmingham Endocrinology Queen Elizabeth Hospital Birmingham University Hospitals Birmingham Liver Unit Queen Elizabeth Hospital Birmingham University Hospital of Birmingham NHS Foundation Trust

Background: Pancreatic neuroendocrine tumors(PNETs) display wide heterogeneity with highly variable prognosis. This study aimed to identify variables related to survival after surgical resection of ***: A total of 143 patients were identified from a prospectively maintained database. Patient characteristics were analyzed and prognostic factors for overall survival and progression-free survival were evaluated. The WHO, ENETS and AJCC scoring systems were applied to the cohort, and their ability to predict patient outcomes were ***: Multivariate analysis found that female gender, lymph node metastases and increasing WHO2010 grade to be independently associated with reduced overall survival(P < 0.05). Patients requiring multi-visceral resection or debulking surgery found to be associated with shortest survival. ROC analysis found the ENETS and AJCC scoring systems to be similarly predictive of 5-year overall survival. Modified Ki67 significantly improved its accuracy in predicting 5-year overall survival(AUROC: 0.699 vs 0.605;P < 0.01).Conclusions: Multi-visceral or debulking surgery is associated with poor outcomes. There seems to be no significant difference between enucleation and anatomical segmental resection. Available scoring systems have reasonable accuracy in stratifying disease severity, with no system identified as being *** stratification with modified grading systems needs further validation before applied in clinical practice.

关键词： Pancreatic neuroendocrine tumors Prognostic factors Validation of staging systems

Venous resection at pancreaticoduodenectomy can be safely performed in the presence of jaundice

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Hepatobiliary & Pancreatic Diseases International 2020年第5期19卷 488-491页

作者： Rupaly Pande James Hodson Ravi Marudanayagam Darius Mirza john isaac Keith J Roberts HPB Surgery University Hospitals Birmingham NHS Foundation TrustBirmingham B152THUK Institute of Translational Medicine University Hospitals Birmingham NHS Foundation TrustBirmingham B152THUK Institute of Immunology and Immunotherapy University of BirminghamBirmingham B152THUK

Venous resection at pancreaticoduodenectomy(PD)has established itself as a viable treatment for borderline resectable cancer,with equivalent survival to those patients undergoing PD for cancer without venous resection[1].Thus surgery for these patients is clearly desirable,when possible,compared to palliative ***,there is concern and debate about the safety of venous resection at PD[2].There is a need to improve patient pathways,outcome and experience[3].To this end,in patients who present with jaundice,it is clear that surgery without preoperative biliary drainage(PBD)reduces complications[4].In 2015,our team introduced a‘fast track’program to routinely perform PD in the presence of jaundice[5].This change of practice has become routine,with most patients now undergoing surgery without *** is,however,unclear whether portal vein(PV)resection+PD is safe in the setting of *** aim of this study,therefore,was to compare outcomes and complications between patients with or without jaundice undergoing PD with associated resection of the superior mesenteric vein(SMV)and/or PV.

关键词： jaundice resection routine

改进的平均应力准则对钛合金断裂强度的评估(英文)

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Transactions of Nonferrous Metals Society of China 2013年第4期23卷 1072-1079页

作者： H.BRIGHTON isaac john T.CHRISTOPHER Sardar Raja College of Engineering AlangulamTirunelveli-627808India Government College of Engineering PerumalpuramTirunelveli-627007India

结构完整性方法通常用来论证工程零件载荷传递的合理性。损伤模型对含尖缺口的钛合金断裂强度的预测取决于材料的无缺口强度以及缺口损伤区前的临界长度。损伤区的临界长度通常取决于材料、试样以及尖缺口的尺寸。平均应力准则作为一种... 详细信息

结构完整性方法通常用来论证工程零件载荷传递的合理性。损伤模型对含尖缺口的钛合金断裂强度的预测取决于材料的无缺口强度以及缺口损伤区前的临界长度。损伤区的临界长度通常取决于材料、试样以及尖缺口的尺寸。平均应力准则作为一种应力断裂准则,常用来对含尖缺口的钛合金抗拉强度进行精确预测。基于不同厚度的中心裂缝钛合金的断裂数据,对平均应力准则进行改进。缺口(断裂)强度的预估值与测试结果接近,表明改进的平均应力准则可以简便地预测缺口的抗拉强度。

关键词：钛合金中心裂纹拉伸试样应力准则失效评估图断裂强度

Distinct risk factors for early and late blood transfusion following pancreaticoduodenectomy

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Hepatobiliary & Pancreatic Diseases International 2018年第4期17卷 349-357页

作者： Sukhchain S.Bansal James Hodson Khalid Khalil Bobby Dasari Ravi Marudanayagam Robert P.Sutcliffe john isaac Keith J.Roberts Department of Hepatobiliary Pancreatic Surgery Queen Elizabeth Hospital BirminghamUniversity Hospitals Birmingham Institute of Translational Medicine Queen Elizabeth Hospital BirminghamUniversity Hospitals Birmingham

Background: The International Study Group of Pancreatic Surgery(ISGPS) has defined two periods of postpancreatectomy hemorrhage, early(24 h). A previously published Blood Usage Risk Score(BURS) aimed to predict early and late blood transfusion. The primary aim of this study was to define risk factors for early and late blood transfusion after pancreaticoduodenectomy. Secondary aims were to assess the predictive accuracy of the ***: In this retrospective observational study, multivariable analyses were used to identify independent risk factors for both early and late blood transfusion. The predictive ability of the BURS was then assessed using a receiver operating characteristic(ROC) curve ***: Among 628 patients, 99(15.8%) and 144(22.9%) received early and late blood transfusion, respectively. Risk factors for blood transfusion differed between early and late periods. Preoperative anemia and venous resection were associated with early blood transfusion whilst Whipple’s resection(as opposed to pylorus preserving pancreaticoduodenectomy), lack of biliary stent and a narrow pancreatic duct were predictors of late blood transfusion. The BURS was significantly predictive of early blood transfusion,albeit with a modest degree of accuracy(AUROC: 0.700, P < 0.001), but not of late blood transfusion(AUROC: 0.525, P = 0.360). Late blood transfusion was independently associated with increasing severity of postoperative pancreatic fistula(POPF)(OR: 1.85, 3.18 and 9.97 for biochemical, types B and C POPF,respectively, relative to no POPF).Conclusions: Two largely different sets of variables are related to early and late blood transfusion following pancreaticoduodenectomy. The BURS was significantly associated with early, albeit with modest predictive accuracy, but not late blood transfusion. An understanding of POPF risk allows assessment of the need for late blood transfusion.

关键词： Pancreatic cancer Blood transfusion Pancreaticoduodenectomy

Characterization of Small-Scale Farmers and Assessment of Their Access to Crop Production Information in Selected Counties of Kenya

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Agricultural Sciences 2024年第5期15卷 565-589页

作者： Anastasia Mumbi Wahome john B. K. Kiema Galcano C. Mulaku isaac Mukoko Department of Geospatial & Space Technology University of Nairobi Nairobi Kenya Department of Public Health Kenya Methodist University Nairobi Kenya

Small-scale farming accounts for 78% of total agricultural production in Kenya and contributes to 23.5% of the country’s GDP. Their crop production activities are mostly rainfed subsistence with any surplus being sold to bring in some income. Timely decisions on farm practices such as farm preparation and planting are critical determinants of the seasonal outcomes. In Kenya, most small-scale farmers have no reliable source of information that would help them make timely and accurate decisions. County governments have extension officers who are mandated with giving farmers advisory services to farmers but they are not able to reach most farmers due to facilitation constraints. The mode and format of sharing information is also critical since it’s important to ensure that it’s timely, well-understood and usable. This study sought to assess access to geospatial derived and other crop production information by farmers in four selected counties of Kenya. Specific objectives were to determine the profile of small-scale farmers in terms of age, education and farm size;to determine the type of information that is made available to them by County and Sub-County extension officers including the format and mode of provision;and to determine if the information provided was useful in terms of accuracy, timeliness and adequacy. The results indicated that over 80% of the farmers were over 35 years of age and over 56% were male. Majority had attained primary education (34%) or secondary education (29%) and most farmers in all the counties grew maize (71%). Notably, fellow farmers were a source of information (71%) with the frequency of sharing information being mostly seasonal (37%) and when information was available (43%). Over 66% of interviewed farmers indicating that they faced challenges while using provided information. The results from the study are insightful and helpful in determining effective ways of providing farmers with useful information to ensure maximum benefits.

关键词： Small Scale Farmers Farmers Crop Production Information Services Geospatial Information Information Access

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让设计工作更加智能

集成电路应用 2012年第4期29卷 40-42页

作者： john isaac Mentor Graphics公司

在Aberdeen集团的一次调查中，众多一流电子公司总结出能积极满足业务目标的六种设计技术最佳实践，随着经济形势的缓慢复苏，它将成为各公司未来发展的重要组成部分。

关键词：设计工作智能电子公司经济形势组成部分