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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 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 ral 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

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The immunology of human cytomegalovirus latency： could latent infection be cleared by novel immunotherapeutic strategies？

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Cellular & Molecular Immunology 2015年第2期12卷 128-138页

作者： Mark r Wills Emma Poole Betty Lau Ben Krishna john H Sinclair Department of Medicine University of Cambridge Cambridge UK

While the host immune response following primary human cytomegalovirus （HCMV） infection is generally effective at stopping virus replication and dissemination, virus is never cleared by the host and like all herpesviruses, persists for life. At least in part, this persistence is known to be facilitated by the ability of HCMV to establish latency in myeloid cells in which infection is essentially silent with, importantly, a total lack of new virus production. However, although the viral transcription programme during latency is much suppressed, a number of viral genes are expressed during latent infection at the protein level and many of these have been shown to have profound effects on the latent cell and its environment. Intriguingly, many of these latency-associated genes are also expressed during lyric infection. Therefore, why the same potent host immune responses generated during lytic infection to these viral gene products are not recognized during latency, thereby allowing clearance of latently infected cells, is far from clear. reactivation from latency is also a major cause of HCMV-mediated disease, particularly in the immune compromised and immune naive, and is also likely to be a major source of virus in chronic subclinical HCMV infection which has been suggested to be associated with long-term diseases such as atherosclerosis and some neoplasias. Consequently, understanding latency and why latenUy infected cells appear to be immunoprivileged is crucial for an understanding of the pathogenesis of HCMV and may help to design strategies to eliminate latent virus reservoirs, at least in certain clinical settings.

关键词： Cytomegalovirus latency immune evasion immunotherapeutic

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Flow turbulence presented by different vegetation spacing sizes within a submerged vegetation patch

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Journal of Hydrodynamics 2023年第6期35卷 1131-1145页

作者： Chukwuemeka Kingsley john Jaan H.Pu Yakun Guo Prashanth r.Hanmaiahgari Manish Pandey Faculty of Engineering and Informatics University of BradfordBradfordUK Department of Civil Engineering Indian Institute of TechnologyKharagpurIndia National Institute of Technology(NIT) WarangalIndia

This study presents results from a vegetation-induced flow experimental study which investigates 3-D turbulence structure profiles,including reynolds stress,turbulence intensity and bursting analysis of open channel *** vegetation densities have been built between the adjacent vegetations,and the flow measurements are taken using acoustic Doppler velocimeter(ADV)at the locations within and downstream of the vegetation *** different tests are conducted,where the first test has compact vegetations,while the second and the third tests have open spaces created by one and two empty vegetation slots within the vegetated *** reveals that over 10%of eddies size is generated within the vegetated zone of compact vegetations as compared with the fewer *** turbulence structures variation is also observed at the points in the non-vegetated *** findings from burst-cycle analysis show that the sweep and outward interaction events are dominant,where they further increase away from the *** effect of vegetation on the turbulent burst cycle is mostly obvious up to approximately two-third of vegetation height where this phenomenon is also observed for most other turbulent structure.

关键词： Velocity profiles acoustic Doppler velocimeter(ADV) turbulent intensities reynolds stress turbulent bursting vegetated flow vegetation spacing sizes

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Management of ischemic proctitis with severe rectal haemorrhage: A case report

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World Journal of Gastroenterology 2006年第23期12卷 3776-3778页

作者： Vincent SK Yip Martin Downey Nee Beng Teo john r Anderson Department of Surgery Southern General HospitalGlasgowUnited Kingdom

Acute ischemic proctitis is a rare pathological condition. We report here a patient presented with massive rectal haemorrhage from a bleeding vessel superimposed on an underlying pathology of ischemic proctitis. This case report illustrates the difficulties in making the clinical distinction between ischemic proctitis and other pathological entities. We also discussed the beneficial role of arteriogram with embolotherapy as an effective therapeutic measure in the management of lower gastrointestinal bleeding. The literature on the subject is reviewed.

关键词： Ischemic proctitis Arteriogram Embolization Gastrointestinal bleeding

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Online single-session interventions for Kenyan adolescents:study protocol for a comparative effectiveness randomised controlled trial

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General Psychiatry 2021年第3期34卷 163-168页

作者： Akash r Wasil Tom Lee Osborn john r Weisz robert J Derubeis Department of Psychology University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Shamiri Institute NairobiKenya Department of Psychology Harvard UniversityCambridgeMassachusettsUSA

Background Mental health problems are the leading cause of disability among adolescents worldwide,yet access to treatment is *** digital interventions have been shown to improve youth mental health,but little is known about which digital interventions are most *** To evaluate the effectiveness of two digital single-session interventions(Shamiri-Digital and Digital-CBT(cognitive-behavioural therapy))among Kenyan *** We will perform a school-based comparative effectiveness randomised controlled *** 926 Kenyan adolescents will be randomly assigned to one of three conditions:Shamiri-Digital(focused on gratitude,growth mindsets and values),Digital-CBT(focused on behavioural activation,cognitive restructuring and problem solving)or a study-skills control condition(focused on note-taking and essay writing skills).The primary outcomes include depressive symptoms(measured by the Patient Health Questionnaire-8),anxiety symptoms(Generalized Anxiety Disorder Screener-7)and subjective well-being(Short Warwick-Edinburgh Mental Well-being Scale).The secondary outcomes include acceptability,appropriateness,primary control and secondary *** and appropriateness will be measured immediately post-intervention;other outcomes will be measured 2 weeks,4 weeks and 12 weeks *** We hypothesise that adolescents assigned to Shamiri-Digital and adolescents assigned to Digital-CBT will experience greater improvements(assessed via hierarchical linear models)than those assigned to the control *** will also compare Shamiri-Digital with Digital-CBT,although we do not have a preplanned *** Our findings will help us evaluate two digital single-session interventions with different theoretical *** effective,such interventions could be disseminated to reduce the public health burden of common mental health problems.

关键词： assigned behaviour Edinburgh

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Correlation between rpoB gene mutation in Mycobacterium avium subspecies paratuberculosis and clinical rifabutin and rifampicin resistance for treatment of Crohn’s disease

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World Journal of Gastroenterology 2008年第17期14卷 2723-2730页

作者： Daniel r Beckler Sammer Elwasila George Ghobrial john F Valentine Saleh A Naser Department of Molecular Biology and Microbiology Burnett School of Biomedical Sciences Center for Biomolecular Sciences College of Medicine University of Central Florida Department of Medicine University of Florida Gainesville

AIM： To investigate overlapping regions of the rpoB gene previously involved with rifamycin resistance in M. tuberculosis and seek correlation between rpoB mutations in dinical MAP strains with susceptibility to rIF and rFB. METHODS： We designed a molecular-based PCr method for the evaluation of rifabutin （rFB） and rifampicin （rIF） resistance based on probable determinant regions within the rpoB gene of MAP, including the 81 bp variable site located between nucleotides 1363 and 1443. The minimum inhibitory concentration （MIC） for rIF was also determined against 11 MAP isolates in attempt to seek correlation with rpoB sequences. rESULTS： We determined that MAP strain 18 had an MIC of 〉 30 mg/L and ≤ 5 mg/L for rIF and rFB respectively, and a significant and novel rpoB mutation C1367T, compared to an MIC of ≤ 1.0 mg/L for both drugs in the wild type MAP. The 30-fold increase in the MIC was a direct result of the rpoB mutation C1367T, which caused an amino acid change Thr456 to Ile456 in the drug＇s binding site. In addition, MAP strain 185 contained five silent rpoB mutations and exhibited an MIC comparable to the wild-type. Moreover, our in vitro selected mutation in MAP strain UCF5 resulted in the generation of a new resistant strain （UCF5-rIF16r） that possessed T1442C rpoB mutation and an MIC 〉 30 mg/L and 〉 10 mg/L for rIF and rFB respectively. Sequencing of the entire rpoB gene in MAP strains UCF4, 18, and UCF5-rIF16r revealed an rpoB mutation A2284C further downstream of the 81 bp variable region in UCF4, accounting for observed slight increase in MIC. In addition, no other significant mutations were found in strains 18 and UCF-rIF16r. CONCLUSION： The data clearly illustrates that clinical and in vitro-selected MAP mutants with rpoB mutations result in resistance to rIF and rFB, and that a single amino acid change in the beta subunit may have a significant impact on rIF resistance. Unconventional drug susceptibility testing such as our molecular approach wi

关键词： Mycobacterium paratuberculosis Crohn's disease rifabutin rifampicin rpoB Minimum inhibitoryconcentration

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Targeting Ageing to Decrease Complex Non-Communicable Human Diseases

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Journal of Genetics and Genomics 2014年第9期41卷 457-458页

作者： Jing-Dong J.Han john r.Speakman Chinese Academy of Sciences Key Laboratory of Computational Biology Chinese Academy of Sciences-Max Planck Partner Institute for Computational BiologyShanghai Institutes for Biological SciencesChinese Academy of Sciences State Key Laboratory of Molecular Developmental Biology Institute of Genetics and Developmental BiologyChinese Academy of Sciences Institute of Biological and Environmental Sciences University of Aberdeen

During the last two centuries, there have been many spectacular advances in medical science, the main consequence of which has been the dramatically reduced burden of infectious diseases. While in the 1800s many people died before reaching adult- hood, nowadays most people survive. Hence average life ex- pectancy in 1800s was around 30-40, which was barely higher than it had been in Greek and roman times （Finch, 2010）, but nowadays life expectancy in most modernised economies is around 75 - 80. This demographic shift, which has happened in only 200 years, has created a dramatic change in the causes of mortality. The major killers in the modern world are non- communicable diseases （NCDs）： principally cardiovascular disease, cancer and neurodegenerative disorders such as Alz- heimer＇s disease. A major factor that influences susceptibility to all these diseases is age. As we get older, our risk of developing these NCDs increases enormously. For example, the rate of breast cancer in females at age 15-19 is less than 10 per 100,000 population, but this increases to 100 at age 40-44, 275 at age 55--59 and 450 at age 85 ＋（http：//***/ cancer-info/cancerstats/types/breast/incidence/#age）. Ageing has consequently become a major medical, social and economic burden to many countries.

关键词： Targeting Ageing to Decrease Complex Non-Communicable Human Diseases

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Effect of music on patients undergoing outpatient colonoscopy

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World Journal of Gastroenterology 2006年第45期12卷 7309-7312页

作者： Matthew L Bechtold rodney A Perez Srinivas r Puli john B Marshall Division of Gastroenterology University of Missouri School of Medicine Columbia Missouri United States

AIM: To evaluate the effect of relaxing music during colonoscopy under low-dose conscious sedation, on patient satisfaction, scope insertion time and procedure duration, medication doses, and the perceived adequacy of sedation and scope insertion difficulty on the part of the endoscopist. METHODS: One hundred and sixty-seven consecutive adult outpatients presenting for routine colonoscopy under low-dose conscious sedation were randomized to undergo their procedures either with music played during the procedure or no music played. rESULTS: There were no statistical differences between the two groups in terms of meperidine dose, midazolam dose, time to reach the cecum, total procedure time, endoscopist assessment of scope insertion difficulty, endoscopist assessment of adequacy of sedation, or the pain experience of the patients during their procedure. The music group did report significantly better overall procedure satisfaction as compared to the non music group on two of our three different scales. CONCLUSION: While music does not result in shortened procedure times, lower doses of sedative medications or perceived patient pain, the patients who have music playing during their procedures report modestly greater satisfaction with their procedures.

关键词： Colonoscopy Gastrointestinal endoscopy Music Music therapy relaxation music

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Intermittent suckling with or without comingling of non-littermate piglets before weaning improves piglet performance in the immediate post-weaning period when compared with conventional weaning

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Journal of Animal Science and Biotechnology 2017年第3期8卷 721-732页

作者： Diana L.Turpin Pieter Langendijk Kate Plush john r.Pluske School of Veterinary and Life Sciences Murdoch UniversityMurdochWA 6150Australia Trouw Nutrition Veerstraat 38Boxmeer 5831 iNThe Netherlands South Australian research and Development Institute Roseworthy CampusJS Davis BuildingRoseworthySA 5371Australia Present address:SunPork Farms 563 Coleman RoadPinkerton PlainsSA 5400Australia

Background： In this experiment, intermittent suckling（IS） with or without the co-mingling（Co M） of piglets was studied as a method to stimulate solid feed intake and reduce post-weaning ***： Three weaning regimes using 30 multiparous sows were compared：（1） conventional weaning（CW）（n = 10 litters）, where piglets had continuous access to the sow until weaning（d 0, farrowing = d-25 relative to weaning）;（2） intermittent suckling（IS）（n = 10 litters）, where piglets were separated from the sow for 8 h/d starting at d-7（relative to weaning）; and（3） intermittent suckling with co-mingling（ISCo）（n = 10 litters） where IS started at d-7 and two litters were housed together during separation and then returned to their original sow. Ad libitum creep feed was available from d-17. At weaning pigs were housed in pens of 11 pigs, 27 pens in total. The ISCo treatment was divided in half to examine effects of different mixing strategies after weaning. Half of the ISCo litters were kept in familiar groups（ISCo F, familiar, n = 4） and the other half were mixed within treatment resulting in groups of unfamiliar pigs（ISCo NF, not familiar, n = 5）, the same as IS（n = 9） and CW（n = 9） ***： The ISCo piglets ate more creep feed in the week before weaning（P 〈 0.01）, but also showed more aggressive and manipulative behaviour on first day of Co M compared with CW piglets（P 〈 0.05）. IS with or without Co M increased exploratory and play behaviour on the first day of treatment intervention（P 〈 0.001） and increased sleeping behaviour on the last day of treatment intervention compared with CW（P 〈 0.001）. Mixing strategy at weaning had an effect on performance data with the highest growth and feed intake seen in ISCo F pigs 2 to 8 d after weaning（P 〈0.001）. IS and ISCo NF pigs also grew faster and ate more than CW pigs 2 to 8 d after weaning（P 〈 0.001）. Post-weaning injury scores suggested reduced aggression in ISCo as evidenced by reduced redness（skin irritation）（P 〈 0.05）, a

关键词： Behaviour Co-mingling Intermittent suckling Piglet Weaning

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A global,high-resolution(30-m)inland water body dataset for 2000:first results of a topographic-spectral classification algorithm

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International Journal of Digital Earth 2016年第2期9卷 113-133页

作者： Min Feng Joseph O.Sexton Saurabh Channan john r.Townshend Global Land Cover Facility Department of Geographical SciencesUniversity of MarylandCollege ParkMDUSA

The science and management of terrestrial ecosystems require accurate,high-resolution mapping of surface *** produced a global,30-m-resolution inland surface water dataset with an automated algorithm using Landsat-based surface reflectance estimates,multispectral water and vegetation indices,terrain metrics,and prior coarse-resolution water *** dataset identified 3,650,723 km2 of inland water globally–nearly three quarters of which was located in North America(40.65%)and Asia(32.77%),followed by Europe(9.64%),Africa(8.47%),South America(6.91%),and Oceania(1.57%).Boreal forests contained the largest portion of terrestrial surface water(25.03%of the global total),followed by the nominal‘inland water’biome(16.36%),tundra(15.67%),and temperate broadleaf and mixed forests(13.91%).Agreement with respect to the Moderate-resolution Imaging Spectroradiometer water mask and Landsat-based national land-cover datasets was very high,with commission errorsrrorsrelative to *** of these were accounted for in the seasonality of water cover,snow and ice,and clouds–effects which were compounded by differences in image acquisition date relative to reference *** Global Land Cover Facility(GLCF)inland surface water dataset is available for open access at the GLCF website(http://***).

关键词： inland water Landsat global high resolution MODIS

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