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Impact of frailty on endoscopic retrograde cholangiopancreatography outcomes in nonagenarians:A United States national experience

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World Journal of Gastrointestinal Endoscopy 2024年第3期16卷 148-156页

作者： Sanket Dhirubhai Basida Dushyant Singh Dahiya Muhammad Nadeem Yousaf Brinda Basida Bhanu Siva Mohan Pinnam Manesh Kumar Gangwani Hassam Ali Sahib Singh Yash r Shah Daksh Ahluwalia Mihir Prakash Shah Saurabh Chandan Neil r Sharma Shyam Thakkar Department of Internal Medicine University of Missouri-ColumbiaColumbiaMO 65212United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Division of Gastroenterology and Hepatology University of MissouriColumbiaMO 65212United States Department of rheumatology Medical College of GeorgiaAugusta UniversityNorth AugustaGA 30912United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Division of Gastroenterology and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Interventional Oncology&Surgical Endoscopy GI Oncology Tumor Site TeamParkview Cancer InstituteParkview HealthFort WayneIN 46845United States Section of Gastroenterology&Hepatology West Virginia University School of MedicineMorgantownWV 26505United States

BACKGrOUND Endoscopic retrograde cholangiopancreatography(ErCP)is an essential therapeutic tool for biliary and pancreatic *** and elderly patients,especially those aged≥90 years are generally considered a higher-risk population for ErCP-related *** To investigate outcomes of ErCP in the Non-agenarian population(≥90 years)concerning *** This is a cohort study using the 2018-2020 National readmission *** aged≥90 were identified who underwent ErCP,using the international classification of diseases-10 code with clinical *** Hopkins’s adjusted clinical groups frailty indicator was used to classify patients as frail and *** primary outcome was mortality,and the secondary outcomes were morbidity and the 30 d readmission rate related to *** used univariate and multivariate regression models for *** A total of 9448 patients were admitted for any indications of *** and non-frail patients were 3445(36.46%)and 6003(63.53%)*** for ErCP were Choledocholithiasis(74.84%),Biliary pancreatitis(9.19%),Pancreatico-biliary cancer(7.6%),Biliary stricture(4.84%),and Cholangitis(1.51%).Mortality rates were higher in frail group[adjusted odds ratio(aOr)=1.68,P=0.02].The Intra-procedural complications were insigni-ficant between the two groups which included bleeding(aOr=0.72,P=0.67),accidental punctures/lacerations(aOr=0.77,P=0.5),and mechanical ventilation rates(aOr=1.19,P=0.6).Post-ErCP complication rate was similar for bleeding(aOr=0.72,P=0.41)and post-ErCP pancreatitis(aOr=1.4,P=0.44).Frail patients had a longer length of stay(6.7 d vs 5.5 d)and higher mean total charges of hospitalization($78807 vs$71392)compared to controls(Preadmission rates between frail and non-frail patients were similar(P=0.96).CONCLUSION There was a significantly higher mortality risk and healthcare burden amongst nonagenarian frail patients undergoing ErCP compared

关键词： Endoscopic retrograde cholangiopancreatography Nonagenarians Frailty Mortality Healthcare burden

Connecting particle sphericity and circularity

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Particuology 2021年第1期19卷 1-4页

作者： john r.Grace Arian Ebneyamini Department of Chemical&Biological Engineering University of British ColumbiaVancouver V6T 1Z3Canada

Sphericity,a measure of how much a particle’s shape deviates from spherical,is useful as a shape factorwhen characterizing particulate ***,particle surface areas,required when determiningthe sphericity,are very difficult to *** a result,the circularity,derivable from microscopic views,is often measured instead and assumed to be equal to the *** paper shows that the twoquantities are generally not equal for simple non-spherical shapes and provides advice on improving theestimation of sphericity from circularity.

关键词： Non-spherical particles Sphericity Circularity Shape factorsa

Effects of the plenum chamber volume and distributor geometry on fluidized bed hydrodynamics

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Particuology 2010年第1期8卷 2-12页

作者： Kiarash Vakhshouri john r. Grace Department of Chemical and Biological Engineering University of British Columbia

Most hydrodynamic fluidized bed models, including CFD codes, neglect any effects of the plenum chamber volume. Experiments were performed in a 0.13 m ID fluidization column to determine plenum chamber volume effects on fluidized bed hydrodynamics for FCC and glass particles. Two low-pressure-drop distributors were used, one with a single orifice, and the other with 33 orifices and the same total open area as the single orifice. The results show two peaks in the frequency spectra for the single-orifice distributor, one representing bubble eruption at the bed surface and the other of higher frequency corresponding to the bubbling frequency at the distributor. The latter decreased slightly with increasing plenum volume and with increasing bed depth. For the multi-orifice distributor, broad frequency spectra from pressure measurements became narrower and moved towards higher frequency with decreasing plenum volume.

关键词： Fluidization Bubble Distributor Plenum chamber Hydrodynamics Pressure drop

Feed- and feed additives-related aspects of gut health and development in weanling pigs

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Journal of Animal Science and Biotechnology 2013年第2期4卷 83-89页

作者： john r Pluske Division of research and Development Murdoch University

The development of new/different management and feeding strategies to stimulate gut development and health in newly-weaned pigs, in order to improve growth performance while minimizing the use of antimicrobial compounds such as antibiotic growth promotants （AGP） and heavy mineral compounds, is essential for the long-term sustainability of the pig industry. Factors including the sub-optimal intake of nutrients and energy, inappropriate microbiota biomass and （or） balance, immature and compromised immune function, and psychosomatic factors caused by weaning can compromise both the efficiency of digestion and absorption and intestinal barrier function through mucosal damage and alteration of tight junction integrity. As a consequence, pigs at weaning are highly susceptible to pathogenic enteric conditions such as post-weaning diarrhea that may be caused by serotypes of enterotoxigenic Escherichia coil Many dietary components, e.g., protein, fiber, feed additives and minerals, are known to influence microbial growth in the gastrointestinal tract that in turn can impact upon pig growth and health, although the relationships between these are sometimes not necessarily apparent or obvious. In a world climate of increased scrutiny over the use of antibiotics per se in pig production, certain feed additives are seen as alternatives/replacements to antibiotics, and have evolved in some cases to have important roles in everyday commercial pig nutrition. Nevertheless and in general, there remains inconsistency and variability in the efficacy of some feed additives and in cases of severe disease outbreaks, for example, therapeutic antibiotics and/or heavy minerals such as zinc oxide （ZnO） are generally relied upon. If feed ingredients and （or） feed additives are to be used with greater regularity and reliability, then it is necessary to better understand the mechanisms whereby antibiotics and minerals such as ZnO influence animal physiology, in conjunction with the use of approp

关键词： Antibiotics Antimicrobials Nutrition Pigs Post-weaning diarrhoea Weaning

Offshore system safety and operational challenges in harsh Arctic operations

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Journal of Safety Science and resilience 2022年第2期3卷 153-168页

作者： Sidum Adumene Hope Ikue-john School of Ocean Technology Marine InstituteMemorial UniversitySt.John’sNL A1C 5R3Canada Department of Marine Engineering and Naval Architecture Akwa Ibom State UniversityNigeria

Offshore oil and gas drilling operations are going to remote and harsh arctic environments with demands forheightened safety and resilience of operational facilities. The remote and harsh environment is characterized byextreme waves, wind, storms, currents, ice, and fog that hinder drilling operations and cause structural failuresof critical offshore infrastructures. The risk, safety, reliability, and integrity challenges in harsh environment operations are critically high, and a comprehensive understanding of these factors will aid operations and protectthe investment. The dynamics, environmental constraints, and the associated risk of the critical offshore infrastructures for safe design, installation, and operations are reviewed to identify the current state of *** paper introduces a systematic review of harsh environment characterization by exploring the metoceanphenomena prevalent in harsh environments and their effects on the floating offshore structures performanceand supporting systems. The dynamics of the floating systems are described by their six degrees of freedom andtheir associated risk scenarios. The systematic methodology further explores the qualitative, quantitative, andconsequences modeling techniques for risk analysis of floating offshore systems in a harsh environment. Whilepresenting the current state of knowledge, the study also emphasizes a way forward for sustainable offshore operations. The study shows that the current state of knowledge is inexhaustive and will require further researchto develop a design that minimizes interruption during remote harsh offshore operations. resilient innovation,IoT and digitalization provide opportunities to fill some of the challenges of remote Arctic offshore operations.

关键词： Critical offshore infrastructure Harsh arctic operations Metocean resilient design Safety Digitalization

Synthetic biology identifies the minimal gene set required for paclitaxel biosynthesis in a plant chassis

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Molecular Plant 2023年第12期16卷 1951-1961页

作者： Youjun Zhang Lorenz Wiese Hao Fang Saleh Alseekh Leonardo Perez de Souza Federico Scossa john Molloy Mathias Christmann Alisdair r.Fernie Max-Planck-Institut fur Molekulare Pflanzenphysiologie Am Muhlenberg 114476 Potsdam-GolmGermany Center of Plant Systems Biology and Biotechnology 4000 PlovdivBulgaria Institute of Chemistry and Biochemistry Freie Universitat BerlinTakustraBe 314195 BerlinGermany Department of Biomolecular Systems Max Planck Institute of Colloids and Interfaces14476 PotsdamGermany research Center for Genomics and Bioinformatics(CrEA-GB) Via Ardeatina 54600178 RomeItaly

The diterpenoid paclitaxel(Taxol)is a chemotherapy medication widely used as a first-line treatment against several types of solid *** supply of paclitaxel from natural sources is ***,missing knowledge about the genes involved in several specific metabolic steps of paclitaxel biosynthesis has rendered it difficult to engineer the full *** this study,we used a combination of transcriptomics,cell biology,metabolomics,and pathway reconstitution to identify the complete gene set required for the heterologous production of *** identified the missing steps from the current model of paclitaxel biosynthesis and confirmed the activity of most of the missing enzymes via heterologous expression in Nicotiana ***,we identified a new C4β-C20 epoxidase that could overcome the first bottleneck of metabolic *** used both previously characterized and newly identified oxomutases/epoxidases,taxane 1β-hydroxylase,taxane 9aα-hydroxylase,taxane 9α-dioxygenase,and phenylalanine-CoA ligase,to successfully biosynthesize the key intermediate baccatin Ill and to convert baccatin Ill into paclitaxel in *** combination,these approaches establisha metabolic route to taxoidbiosynthesis and provide insights into the unique chemistry that plants use to generate complex bioactive metabolites.

关键词： paclitaxel biosynthesis synthetic biology baccatin Ill biosynthesis Taxus

Integrative genomic and transcriptomic profiling of pulmonary sarcomatoid carcinoma identifies molecular subtypes associated with distinct immune features and clinical outcomes

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Cancer Innovation 2024年第3期3卷 81-94页

作者： Sahil Seth runzhe Chen Yang Liu Junya Fujimoto Lingzhi Hong Alexandre reuben Susan Varghese Carmen Behrens Tina McDowell Luisa Solis Soto Cara Haymaker Annikka Weissferdt Neda Kalhor Jia Wu Xiuning Le Natalie I Vokes Chao Cheng john V.Heymach Don L.Gibbons P.Andrew Futreal Ignacio IWistuba Humam Kadara Jianhua Zhang Cesar Moran Jianjun Zhang Department of Genomic Medicine The University of Texas MD Anderson Cancer CenterHoustonTexasUSA TrACTION The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Graduate School of Biomedical Sciences The University of Texas MD Anderson and the University of Texas Health Science CenterHoustonTexasUSA Department of Thoracic/Head and Neck Medical Oncology The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Department of Translational Molecular Pathology The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Department of Epidemiology The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Department of Pathology The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Department of Imaging Physics The University of Texas MD Anderson Cancer CenterHoustonTexasUSA Department of Medicine Baylor College of MedicineHoustonTexasUSA

Background:Pulmonary sarcomatoid carcinoma(PSC)is a rare and aggressive subtype of non-small cell lung cancer(NSCLC),characterized by the presence of epithelial and sarcoma-like *** molecular and immune landscape of PSC has not been well ***:Multiomics profiling of 21 pairs of PSCs with matched normal lung tissues was performed through targeted high-depth DNA panel,whole-exome,and rNA *** describe molecular and immune features that define subgroups of PSC with disparate genomic and immunogenic features as well as distinct clinical ***:In total,27 canonical cancer gene mutations were identified,with TP53 the most frequently mutated gene,followed by ***,most TP53 and KrAS mutations were earlier genomic events mapped to the trunks of the tumors,suggesting branching evolution in most PSC *** identified two distinct molecular subtypes of PSC,driven primarily by immune infiltration and *** Immune High(IM-H)subtype was associated with superior survival,highlighting the impact of immune infiltration on the biological and clinical features of localized ***:We provided detailed insight into the mutational landscape of PSC and identified two molecular subtypes associated with ***-H tumors were associated with favorable recurrence-free survival and overall survival,highlighting the importance of tumor immune infiltration in the biological and clinical features of PSCs.

关键词： genomic immune pulmonary sarcomatoid carcinoma survival

Quantum Field Theory Deserves Extra Help

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Journal of High Energy Physics, Gravitation and Cosmology 2022年第2期8卷 265-268页

作者： john r. Klauder Department of Physics and Department of Mathematics University of Florida Gainesville FL USA

Today's quantum field theory (QFT) relies heavenly on canonical quantization (CQ), which fails for φ44 leading only to a “free” result. Affine quantization (AQ), an alternative quantization procedure, leads to a “non-free” result for the same model. Perhaps adding AQ to CQ can improve the quantization of a wide class of problems in QFT.

关键词： Quantum Field Theory Canonical Quantization (CQ) Affine Quantization (AQ)

Chowing down:diet considerations in rodent models of metabolic disease

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Life Metabolism 2023年第3期2卷 10-18页

作者： Kevin C.Klatt Kevin Bass john r.Speakman Kevin D.Hall Department of Nutritional Sciences and Toxicology University of California BerkeleyBerkeleyCA 94720United States Garrison Institute of Aging Texas Tech University Health Science CenterLubbockTX 79430United States Center for Energy Metabolism and reproduction Shenzhen Institutes of Advanced TechnologyChinese Academy of SciencesShenzhenGuangdong 518055China National Institute of Diabetes and Digestive and Kidney Diseases National Institutes of HealthBethesdaMD 20892United States

Diet plays a substantial role in the etiology, progression, and treatment of chronic disease and is best considered as a multifacetedset of modifiable input variables with pleiotropic effects on a variety of biological pathways spanning multiple organ systems. Thisbrief review discusses key issues related to the design and conduct of diet interventions in rodent models of metabolic disease andtheir implications for interpreting experiments. We also make specific recommendations to improve rodent diet studies to help betterunderstand the role of diet on metabolic physiology and thereby improve our understanding of metabolic disease.

关键词： diet composition nutrition chow study design recommendations