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Predictors of survival in autoimmune liver disease overlap syndromes

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World Journal of Hepatology 2024年第9期16卷 1269-1277页

作者： Dujinthan Jayabalan Yi Huang Luis Calzadilla-Bertot Malik Janjua Bastiaan de Boer john Joseph Wendy Cheng Simon Hazeldine Briohny W Smith Gerry C MacQuillan Michael C Wallace George Garas Leon A Adams Gary P jeffrey Medical School University of Western AustraliaNed-lands 6009Western AustraliaAustralia Department of Hepatology Sir Charles Gairdner HospitalNedlands 6009Western AustraliaAustralia Department of Anatomical Pathology PathWest Laboratory MedicineNedlands 6009Western AustraliaAustralia Department of Gastroenterology and Hepatology Royal Perth HospitalPerth 6000Western AustraliaAustralia Department of Gastroenterology and Hepatology Fiona Stanley HospitalMurdoch 6150Western AustraliaAustralia Medical School University of Western AustraliaNedl-ands 6009Western AustraliaAustralia

BACKGROUND Survival in patients with autoimmune liver disease overlap syndromes(AILDOS)compared to those with single autoimmune liver disease is *** To investigate the survival of patients with AILDOS and assess the accuracy of non-invasive serum models for predicting liver-related *** Patients with AILDOS were defined as either autoimmune hepatitis and primary biliary cholangitis overlap(AIH-PBC)or autoimmune hepatitis and primary sclerosing cholangitis overlap(AIH-PSC)and were identified from three tertiary centres for this cohort ***-related death or transplantation(liver-related mortality)was determined using a population-based data linkage *** scores for liver-related death were compared for accuracy[including liver outcome score(LOS),Hepascore,Mayo Score,model for end-stage liver disease(MELD)score and MELD incorporated with serum sodium(MELD-Na)score].RESULTS Twenty-two AILDOS patients were followed for a median of 3.1 years(range,0.35-7.7).Fourteen were female,the median age was 46.7 years(range,17.8 to 82.1)and median Hepascore was 1(range,0.07-1).At five years post enrolment,57%of patients remained free from liver-related mortality(74%AIH-PBC,27%AIH-PSC).There was no significant difference in survival between AIH-PBC and *** was a significant predictor of liver-related mortality(P<0.05)in patients with AIH-PBC(n=14)but not AIH-PSC(n=8).A LOS cut-point of 6 discriminated liver-related mortality in AIH-PBC patients(P=0.012,log-rank test,100%sensitivity,77.8%specificity)(Harrell's C-statistic 0.867).The MELD score,MELD-Na score and Mayo Score were not predictive of liver-related mortality in any *** Survival in the rare,AILDOS is *** current study supports the LOS as a predictor of liver-related mortality in AIH-PBC *** trials investigating predictors of survival in AILDOS are required.

关键词： Autoimmune liver disease overlap syndromes Liver outcome score Liver-related death Hepascore Autoimmune hepatitis Primary biliary cholangitis Primary sclerosing cholangitis

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

Effects of ambient DIN:DIP ratio on the nitrogen uptake of harmful dinoflagellate Prorocentrum minimum and Prorocentrum donghaiense in turbidistat

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Chinese Journal of Oceanology and Limnology 2011年第4期29卷 746-761页

作者：李纪 Patricia M. GLIBERT jeffrey A. alexander University of Maryland Center for Environmental Science Horn Point Laboratory PO Box 775 Cambridge MD 21613 USA

The effects of varying nitrogen （N）： phosphorus （P） ratios on the growth and N-uptake and assimilation of the harmful dinoflagellates Prorocentrum minimum and Prorocentrum donghaiense were examined in turbidistat culture experiments. Algal cultures were supplied with media containing PO4^3- in various concentrations to obtain a wide range of N：P ratios. Experiments to determine rates of N uptake and assimilation of different N sources （NO^3-, NH4^＋, urea and glycine by P. minimum and NO3^-, NH4^＋ by P. donghaiense） were conducted using ^15-N tracer techniques at each N：P ratio. The growth rates suggested nutrient limitation at both high and low N：P ratios relative to the Redfield ratio. On a diel basis, the growth of both species was regulated by the light-dark cycle, which may be a result of regulation of both lightdependent growth and light-independent nutrient uptake. Maximum growth rates of both species always occurred at the beginning of light phase. In P-rich medium （low N：P ratio）, both species had higher N assimilation rates, suggesting N limitation. Low assimilation coefficients at high N：P ratios suggested P limitation of N uptake and assimilation. NO3 ^-and NH4^＋ contributed more than 90% of the total N uptake of P. minimum. Reduced N sources were more quickly assimilated than NO3^-. Highest average daily growth rates were recorded near an N：P ratio of 12 for both species. The N uptake rates of cultures at N：P ratios near Redfield ratio were more balanced with growth rates. The linkage between growth rates and N uptake/assimilation rates were conceptually described by the variation of cell N quota. The N：P ratios affect the N uptake and growth of Prorocentrum spp., and may regulate their bloom progression in eutrophic ecosystems.

关键词： harmful dinoflagellate N:P ratio nitrogen uptake continuous culture Prorocentrum spp

Assessment of multi-modality evaluations of obscure gastrointestinal bleeding

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World Journal of Gastroenterology 2017年第4期23卷 614-621页

作者： Ryan Law Jithinraj E Varayil Louis M Wong Kee Song Jeff Fidler Joel G Fletcher john barlow.jeffrey alexander Elizabeth Rajan Stephanie Hansel Brenda Becker Joseph J Larson Felicity T Enders David H Bruining Nayantara Coelho-Prabhu Division of Gastroenterology and Hepatology Mayo Clinic Division of Radiology Mayo Clinic Division of Health Sciences Research Mayo Clinic

AIMTo determine the frequency of bleeding source detection in patients with obscure gastrointestinal bleeding (OGIB) who underwent double balloon enteroscopy (DBE) after pre-procedure imaging [multiphase computed tomography enterography (MPCTE), video capsule endoscopy (VCE), or both] and assess the impact of imaging on DBE diagnostic *** cohort study using a prospectively maintained database of all adult patients presenting with OGIB who underwent DBE from September 1st, 2002 to June 30th, 2013 at a single tertiary *** hundred and ninety five patients (52% females; median age 68 years) underwent DBE for OGIB. AVCE and/or MPCTE performed within 1 year prior to DBE (in 441 patients) increased the diagnostic yield of DBE (67.1% with preceding imaging vs 59.5% without). Using DBE as the gold standard, VCE and MPCTE had a diagnostic yield of 72.7% and 32.5% respectively. There were no increased odds of finding a bleeding site at DBE compared to VCE (OR = 1.3, P = 0.150). There were increased odds of finding a bleeding site at DBE compared to MPCTE (OR = 5.9, P < 0.001). In inpatients with overt OGIB, diagnostic yield of DBE was not affected by preceding *** is a safe and well-tolerated procedure for the diagnosis and treatment of OGIB, with a diagnostic yield that may be increased after obtaining a preceding VCE or MPCTE. However, inpatients with active ongoing bleeding may benefit from proceeding directly to antegrade DBE.

关键词： Double balloon enteroscopy Computed tomography enterography Video capsule enteroscopy Obscure gastrointestinal bleeding

The Crisis of Journalism Reconsidered： Cultural Power

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Fudan Journal of the Humanities and Social Sciences 2015年第1期8卷 9-31页

作者： jeffrey C. alexander Department of Sociology Yale University PO Box 208265 New Haven CT 06520-8265 USA

Recent technological change and the economic upheaval it has produced are coded by social meanings. Cultural codes not only trigger technological and economic changes, but also provide pathways to control them, allowing the dem- ocratic practices of independent journalism to be sustained in new forms. Even as they successfully defend their professional ethics, however, journalists experience them as vulnerable to subversion in the face of technological and economic change. Indeed, independent journalists and the social groups who support them often feel as if they are losing the struggle for autonomy. Just as current anxieties have been triggered by computerization and digital news, so were earlier crises of journalism linked to technological shifts that demanded new forms of economic organization. Digital production has created extraordinary organizational upheaval and economic strain. At the same time, critical confrontations with digital production have trig- gered innovative organizational forms that allow new technologies to sustain, rather than undermine, the democratic culture and institution of news production. If news producers are making efforts to adapt professional journalism to the digital age while maintaining journalistic civil values, there are parallel adaptations from the digital side： digital journalism becoming more like professional journalism.

关键词： Civil sphere Journalism Cultural sociology. Crisis of journalism Citizen journalism Professional journalism

Fudan Journal of the Humanities and Social Sciences： Introduction to Special Section Cultural Sociology and Journalism

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Fudan Journal of the Humanities and Social Sciences 2015年第1期8卷 1-7页

作者： jeffrey C. alexander Yale University New Haven CT USA

The essays that follow in this Special Section were initially formulated as contributions to a forthcoming book, The Crisis of Journalism Reconsidered： Cultural Power （alexander et al. 2015）. They are its three pivotal essays, presenting the most theoretically developed and empirically grounded exemplifications of the cultural- sociological approach that makes the volume distinct. As the reader will see, it is because these essays are cultural-sociological that they are able to bring a dramatically different perspective to bear on the contemporary crisis of journalism. Rather than seeing technological and economic change as the primary causes of current anxieties, each essay draws special attention to the role played by the cultural commitments of journalism itself. Each links the professional ethics to the democratic aspirations of the broader societies in which journalists ply their craft, insisting that new digital technologies are being shaped to sustain value commitments rather than undermining them. In this brief introduction to the Special Section, I provide a broader context for the distinctive perspective that informs these three essays. First, I contrast the cultural-sociological approach with the reductionism that marks other contemporary approaches to journalism. Second, I situate cultural sociology theoretically in the broad historical arc of social thought.

关键词：社会学文化节新闻业人文社会科学专辑学报数字技术职业道德

Machine Learning Chemical Guidelines for Engineering Electronic Structures in Half-Heusler Thermoelectric Materials

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Research 2020年第1期2020卷 978-985页

作者： Maxwell TDylla alexander Dunn Shashwat Anand Anubhav Jain G.jeffrey Snyder Department of Materials Science and Engineering Northwestern UniversityIL 60208USA Department of Materials Science and Engineering UC BerkeleyCA 94720USA Lawrence Berkeley National Laboratory Energy Technologies AreaCA 94720USA

Half-Heusler materials are strong candidates for thermoelectric applications due to their high weighted mobilities and power factors,which is known to be correlated to valley degeneracy in the electronic band ***,there are over 50 known semiconducting half-Heusler phases,and it is not clear how the chemical composition affects the electronic *** all the n-type electronic structures have their conduction band minimum at either theΓ-or X-point,there is more diversity in the p-type electronic structures,and the valence band maximum can be at either theΓ-,L-,or ***,we use high throughput computation and machine learning to compare the valence bands of known half-Heusler compounds and discover new chemical guidelines for promoting the highly degenerate W-point to the valence band *** do this by constructing an“orbital phase diagram”to cluster the variety of electronic structures expressed by these phases into groups,based on the atomic orbitals that contribute most to their valence ***,with the aid of machine learning,we develop new chemical rules that predict the location of the valence band maximum in each of the *** rules can be used to engineer band structures with band convergence and high valley degeneracy.

关键词： structure valence bands

Pancreatic paraganglioma diagnosed by endoscopic ultrasoundguided fine needle aspiration: A case report and review of literature

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World Journal of Gastroenterology 2021年第37期27卷 6322-6331页

作者： Gandhi Lanke john M Stewart jeffrey H Lee Department of Gastroenterology Hepatology and NutritionMD Anderson Cancer CenterLubbockTX 79407United States Pathology-lab Medicine Division MD Anderson Cancer CenterHoustonTX 77030United States Department of Gastroenterology Hepatology and NutritionMD Anderson Cancer CenterHoustonTX 77030United States

BACKGROUND Pancreatic paragangliomas(PPGL)are rare benign neuroendocrine neoplasms but malignancy can *** are often misdiagnosed as pancreatic neuroendocrine tumor or pancreatic *** SUMMARY We reviewed 47 case reports of PPGL published in PubMed to *** patients(15/47)with PPGL underwent endoscopic ultrasound-guided fine needle aspiration(EUS-FNA).Only six(6/15)were correctly diagnosed as *** patients with PPGL underwent surgical resection except three(one patient surgery was aborted because of hypertensive crisis,two patients had metastasis or involvement of major vessels).Our patient remained on close surveillance as she was *** Accurate preoperative diagnosis of PPGL can be safely achieved by EUS-FNA with *** team approach should be considered to bring the optimal results in the management of PPGL.

关键词： Pancreatic paraganglioma Endoscopic ultrasound-guided fine needle aspiration Meta-iodobenzylguanidine scan Metanephrines GATA-3 Immunohistochemistry Case report

AAV8 transduction capacity is reduced by prior exposure to endosome-like pH conditions

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Neural Regeneration Research 2021年第5期16卷 851-855页

作者： jeffrey ALowell Kar Men Mah john LBixby Vance PLemmon Miami Project to Cure Paralysis University of MiamiMiamiFLUSA Department of Neurological Surgery University of MiamiMiamiFLUSA Department of Molecular and Cellular Pharmacology University of MiamiMiamiFLUSA

Adeno-associated virus(AAV)is an essential instrument in the neuroscientist’s toolkit,which allows delivery of DNA to provide labeling with fluorescent proteins or genetic instructions to regulate gene *** the field of neural regeneration,the transduction of neurons enables the observation and regulation of axon growth and regeneration,and in the future will likely be a mechanism for delivering molecular therapies to promote sprouting and regeneration after central nervous system *** formulations of AAV preparations permit efficient viral transduction under physiologic conditions,but an improved understanding of the mechanistic limitations of AAV transduction may facilitate production of more resilient AAV strains for investigative and therapeutic *** studied AAV transduction in the context of prior exposure of AAV serotype 8(AAV8)to environmental pH within the range encountered during endosomal endocytosis(pH 7.4 to pH 4.4),during which low pH-triggered structural and autoproteolytic changes to the viral capsid are believed to be necessary for endosome escape and virus *** to the fundamental nature of these processes,we hypothesized that premature exposure of AAV8 particles to acidic pH would decrease viral transduction of HT1080 cells in vitro,as measured by fluorescent reporter gene expression using high-content imaging *** found that increasingly acidic incubation conditions were associated with concomitant reductions in transduction efficiency,and that quantitative levels of reporter gene expression in transduced cells were similarly *** biggest decrease in transduction occurred between pH 7.4 and pH 6.4,suggesting the possible co-occurrence of a pH-associated event and viral inactivation within that *** together,these findings indicate that exposure of AAV8 to acidic pH for as little as 1 hour is deleterious to transduction *** studies are necessary to understand the pH-associated

关键词： adeno-associated virus autolytic capsid low pH protease proteolytic temperature trafficking transduction viral inactivation